Purchase College Fitness Program Membership Form - Summer 2026

  • PLEASE FILL OUT ALL FIELDS. ONCE SUBMITTED PLEASE BRING CASH OR CHECK IN PERSON TO COMPLETE THE REGISTRATION PROCESS.

  • Spring Semester - 6/1/26 through 7/31/26

    *Closed July 3*


    Fitness Center

    Monday through Thursday 8:00am-5:00pm
    Friday 8:00am-4:00pm

    Closed Weekends

    Pool - Open Lap Swim

    Monday through Friday 7:30-9:00am

    Closed Weekends

     

     

    Pickleball/Racquetball/Tennis Courts

    by appointment only

  • Summer 2026*

  • REGISTRATION/PAYMENT HOURS:

  • BY APPOINTMENT ONLY- please select a time and date below that you would like to come to complete the registration process. Payment can be submitted to Adam Taraska on the 3rd floor office area.

  • Date you plan to drop off cash or check*
     / /
  • Format: (000) 000-0000.

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  • Membership includes use of the pool, fitness center, racquetball courts, squash courts, outdoor tennis, locker rooms, saunas.

  • Individual membership is defined as any person 18 years or older. Family membership is defined as two persons (married couple, domestic partners, or a parent w/ family members under 18 years old). Each individual family member less than 18 years old may be registered for an additional charge.

  • LOCKER REGISTRATION

  • Lockers are available as part of the membership fee. Locker registration allows use of a specific locker with your own lock for the duration of the membership period.

    ALL LOCKS AND LOCKER CONTENTS MUST BE CLEARED BY THE EXPIRATION DATE ALL CONTENTS WILL BE DISCARDED AFTER THE SEMESTER ENDS

  • LOCKER ROOM

  • PHYSICAL ACTIVITY READINESS QUESTIONNAIRE

    ***PLEASE FILL OUT ALL QUESTIONS***

    Your application will not be accepted if all questions are not answered Regular physical activity is healthy and safe for most people. However, some people should check with their physician before they start becoming more physically active. If you are planning on becoming more pyisycally acitve than you are now, you should start by filling out this questionnaire and undergoing a medical examination from your personal physician. This questionnaire is not a subsitute for a medicam exam and should be answered as accurately and honestly as possible. If you feel you have any medical conditions that may be harmful to you, Purchase College strongly reccomends that you seek medical attendtion before beginning an exercise program.

  • Do you exercise regularly?*
  • Have you ever been told by a physician not to exercise?*
  • Do you currently have an illness or infection?*
  • Have you had surgery or been hospitalized in the past year?*

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  • Are you currently on any medications?*

  • Do any of the following apply to you?

  • Diabetes*
  • Liver disorder/disease*
  • Kidney disorder/disease*
  • High blood pressure*
  • Currently pregnant?*
  • Abnormal mentstrual cycle*

  • Cardiovascular history: With mild to moderate exertion do the following apply to you?

  • Chest Pain*

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  • Shortness of breath*
  • Pain in legs or arms*
  • Dizziness or fainting*
  • Do you have a known heart condition*

  • Pulmonary History: Do any of the following apply to you?

  • Asthma*
  • Emphysema*
  • Sport induced Asthma*
  • Current smoker*
  • Do you have a known pulmonary condition?*

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  • Musculoskeletal History: Do any of the following apply to you?

  • Do you have a known musculoskeletal condition?
  • Arthritis*
  • Osteoporosis*
  • Multiple Sclerosis*
  • Muscular Dystrophy*

  • I agree to abide by the regulations of the fitness program. I realize the refund policy for membership cancellation is 100% during week 1, and 70% during week 2, and that the facitily is closed when classes are not in session unless otherwise announced. The program reserves the right to terminate membership without refund if rules and regulations are not abided by or if innapropriate behavior is exhibited. Classes, intramurals, athletics and special events have priority in the facility, and hours are subject to change. Locker contents will be discarded after the expiration date of the membership.

  • Date
     / /

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