• FITNESS, BJJ, MUAY THAI, BOXERCISE MEMBERSHIP FORM

    Please use this form when signing up to Bushey Islamic Circle's Fitness, BJJ, Boxercise activities. This form applies for any of the Physical Activity classes or sessions described in this Form.
  • SECTION 1: DATA PRIVACY AND ACCESS TO DATA

  • 1. Data Privacy and Access to Data or confidential information

    1.1 As a Member of Bushey Islamic Circle's Fitness, BJJ or Boxercise activities, you may have access to (or may learn of) information of a confidential nature including personal volunteer, donor and/or member details. Confidential information includes the contents of Bushey Islamic Circle's operating manual, which should not be disclosed to people outside of the project. When someone gives us any confidential information, they need to be sure that we will not pass this on to anyone else without their prior permission. The only exception to this is if you have been party to any information which raises a concern to you, such as a safeguarding matter. In this case, you will be expected to share this with the nominated safeguarding person for Bushey Islamic Circle. Confidential information includes (but is not limited to) payment machines, data stored on a electronic device or computer, data collection system entries, spoken words and presentations, printed documents, loose notes, diaries, memoranda, drawings, photographs, electronic, magnetic and optical storage, and computer printouts.
  • 2. Confidentiality Statement

    2.1 You understand that while using the services of Bushey Islamic Circle you may come across information that is confidential. You agree that you will never disclose such confidential information to anyone outside of the class, subject to the exception outlined above. You also agree to respect the intellectual property of Bushey Islamic Circle and not to pass on any data or documentation you may use in the course of my relationship with Bushey Islamic Circle to anyone outside of the program. You understand breaches of this agreement could result in termination of membership with Bushey Islamic Circle.
  • 3. Purpose

    3.1 Purpose: You agree to accept services from Bushey Islamic Circle in the capacity as Member ("Member") or Participant ("Participant"). In the course of using these Services, you as the Member/ Participant may have access to confidential information of Bushey Islamic Circle.
  • 4. Definition of Confidential Information

    4.1 Definition of Confidential Information: Confidential Information shall include, but not be limited to, any and all information related to the Bushey Islamic Circle's operations, finances, donors, beneficiaries, projects, strategies, plans, intellectual property, and any other information identified by Bushey Islamic Circle as confidential.
  • 5. Confidentiality Obligations

    5.1 Confidentiality Obligations: The Member agrees to maintain the confidentiality of all Confidential Information obtained during the course of accepting the Services to Bushey Islamic Circle. The Member shall not disclose, directly or indirectly, any Confidential Information to any third party without the prior written consent of the Bushey Islamic Circle.
  • 6. Use of Confidential Information

    6.1 Use of Confidential Information: The Member agrees to use Confidential Information solely for the purpose of using the Services provided by Bushey Islamic Circle. The Member shall not use Confidential Information for any other purpose without the prior written consent of the Bushey Islamic Circle.
  • 7. Exceptions

    7.1 Exceptions: The obligations of confidentiality under this Agreement you shall not apply to any information which: (a). is already known to you as the Member at the time of disclosure and is not subject to any other confidentiality obligation; (b). Becomes publicly known through no fault of the Member; (c). Is independently developed by the Member without the use of Confidential Information; (d). Is rightfully obtained by the Member from a third party without restriction on disclosure; or (e). Is required to be disclosed by law or a valid court order, provided that the Member gives prompt notice to the Bushey Islamic Circle to allow the Charity to seek a protective order or other appropriate remedy.
  • 8. Return of Confidential Information

    8.1 Return of Confidential Information: Upon termination or conclusion of the Member's relationship with Bushey Islamic Circle or upon request, Bushey Islamic Circle shall promptly return or destroy all Confidential Information, including any copies or reproductions thereof, in Bushey Islamic Circle's possession or control.
  • 9. Duration

    9.1 Duration: The obligations under this Agreement shall survive the termination of the Members's relationship with Bushey Islamic Circle and shall continue for a period of six years from the date of termination.
  • SECTION 2: MEMBERSHIP TERMS AND CONDITIONS

    10.1 Please ensure you read and understand the following Terms and Conditions before you sign up.
  • 10. Terms and Conditions Explained: Risk of harm or injury

    Bushey Islamic Circle's: Fitness, Brazilian Jiu Jitsu, and Boxercise Program. Terms and Conditions. Assumption of Risk: Participation in martial arts such as Brazilian Jiu Jitsu and boxercise for self defence, as well as fitness and exercise classes, inherently carries a risk of harm and injury. As a member you acknowledge and accept these risks as part of participation in the programs or services offered by Bushey Islamic Circle.
  • 11. Disclaimer

    Disclaimer: By enrolling in any of the programs offered by Bushey Islamic Circle, you agree to waive any claims against Bushey Islamic Circle, its officers, coaches, instructors, and representatives for any injury, harm, or damage that may occur during or as a result of your participation. You understand that you are solely responsible for your own safety during training sessions and events and should take all steps to follow the proper and correct instruction of the Instructor, Coach or officer of Bushey Islamic Circle.
  • 12. Waiver of Liability

    Waiver of Liability: by signing this Agreement you hereby acknowledge that you are voluntarily participating in the Fitness, Brazilian Jiu Jitsu, and Boxercise programs offered by Bushey Islamic Circle ("BIC"). You understand that participation in these activities carries inherent risks of harm and injury, including but not limited to, bodily injury, sprains, strains, fractures, concussion, or even death. You voluntarily assume all risks associated with your participation in these programs. You understand and acknowledge that BIC, its officers, coaches, instructors, and representatives cannot guarantee your safety or prevent accidents from occurring during training sessions and events. You acknowledge that BIC has advised you to obtain medical clearance from a qualified healthcare professional before participating in these activities, and you affirm that you have either obtained such clearance or voluntarily chosen to participate without it. In consideration of being permitted to participate in the programs offered by BIC, you hereby waive, release, and discharge BIC, its officers, coaches, instructors, and representatives from any and all liability for any injury, harm, or damage that may occur to you during or as a result of your participation in these activities. This waiver includes, but is not limited to, liability for negligence, gross negligence, or recklessness on the part of BIC or its agents. You further agree to indemnify and hold harmless BIC, its officers, coaches, instructors, and representatives from any and all claims, demands, actions, or causes of action arising out of or in connection with my participation in the programs offered by BIC. You understand that this waiver of liability is a binding legal agreement and that you are giving up certain legal rights by signing it.
  • 13. Medical Clearance Explained:

    Medical Clearance: Participants affirm that they are in good physical condition and have no medical conditions that would prevent them from safely participating in the programs offered by BIC. Participants agree to seek medical clearance from a qualified healthcare professional if they have any concerns regarding their health or ability to participate.
  • 14. Code of Conduct:

    Code of Conduct: Participants agree to conduct themselves in a respectful and sportsmanlike manner at all times during training sessions and events. Any behavior deemed inappropriate or disruptive by BIC staff or instructors may result in disciplinary action, including termination of membership.
  • 15. Payment and Fees:

    Payment and Fees: Participants agree to pay all membership fees and dues in a timely manner as specified by Bushey Islamic Circle. Failure to make payments may result in suspension or termination of membership. Payment should be made directly to the Bank Account of Bushey Islamic Circle which will be forwarded to you once you have signed this Agreement.
  • 16. Cancellation and Refunds:

    Cancellation and Refunds: Participants understand that membership fees and monthly fees are non-refundable except in cases where Bushey Islamic Circle cancels a program or event. Participants may request to cancel their membership in writing, and refunds will be provided at the discretion of Bushey Islamic Circle management.
  • 17. Use of Facilities, Equipment and Services:

    Use of Facilities, Equipment and Services: Participants agree to use BIC facilities and equipment responsibly and in accordance with the instructions provided by BIC staff and instructors. Participants are responsible for any damage to facilities or equipment caused by their negligence or misuse.
  • 18. Photography and Media:

    Photography and Media: Participants consent to the use of their likeness in photographs, videos, and other media for promotional purposes by BIC. Participants may request in writing to opt-out of such use of their likeness.
  • 19. Changes to Terms and Conditions

    Changes to Terms and Conditions: BIC reserves the right to amend or update these terms and conditions at any time. Participants will be notified of any changes, and continued participation in the programs offered by BIC will constitute acceptance of the revised terms and conditions. By signing this Agreement, you acknowledge that you have read and fully understand the terms of this waiver, and you voluntarily agree to its terms.
  • SECTION 3: PARTICIPATION GUIDELINES: Hygiene, Health and Conditions

    Guidelines for Brazilian Jiu Jitsu and Muay Thai Participants: Personal Hygiene and Health/Trimming of Nails: Keep your nails trimmed short to prevent scratching or injuring yourself and others during training. Long nails can easily tear skin or cause abrasions, so it's important to maintain them regularly. Oral Hygiene: Maintain good oral hygiene by brushing your teeth and using mouthwash regularly. Bad breath can be off-putting for training partners, so it's essential to maintain fresh breath during training sessions. Body Odor: Take a shower before attending training sessions to ensure you are clean and free from body odor. Use deodorant or antiperspirant to minimize body odor during training. Washing of Training Clothing or Gi (Kimono):Wash your training clothing or Gi (kimono) after every training session to prevent the buildup of bacteria and odors. Use a mild detergent and wash in hot water to effectively remove sweat and bacteria. Avoiding Training When Ill: Do not attend training sessions if you are feeling unwell or exhibiting symptoms of illness, such as a cold, flu, or COVID-19.Training while ill not only compromises your own health but also increases the risk of spreading illness to others in the gym. Skin Rashes or Diseases: Refrain from training if you have any skin rashes, infections, or diseases such as ringworm. Skin conditions can easily spread among training partners, so it's crucial to seek treatment and avoid training until the condition has cleared up. Additional Tips: Wash your hands frequently, especially before and after training sessions, to prevent the spread of germs. Use hand sanitizer if soap and water are not readily available. Cover any cuts, scratches, or open wounds with clean bandages or dressings to prevent infection and minimize the risk of spreading bloodborne pathogens. Avoid sharing personal items such as towels, water bottles, or equipment with other participants to reduce the risk of cross-contamination. By following these guidelines, you not only maintain your own personal hygiene and health but also contribute to a clean and safe training environment for yourself and your training partners.
  • 20. Governing Law

    10.1 Governing Law: This Agreement shall be governed by and construed in accordance with the laws of England and Wales.
  • SECTION 4: ABOUT YOU

    In this section you tell us who you are
  • Date of Birth*
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  • Select your Classes

    In this section you tell us what your are signing up to:
  • Select what you are signing up for:*
  • Physical Activity Readiness Questionnaire: REPs

    In this section you tell us about any medical conditions our instructors need to be aware of. Please note: your answers may affect the delivery of the sessions/ or your ability to participate in any of the session Bushey Islamic Circle offer.
  • Please read each question carefully

    If you are between the ages of 16 and 69, this questionnaire will tell you if you should check with your doctor before you significantly change your physical activity patterns. If you are over 60 years of age, and are not used to being very active, you should check with your doctor. Please read each question carefully and answer honestly by indicating YES or NO.
  • Has your doctor ever said you have heart condition and that you should only do physical activity recommended by your doctor?*
  • Do you feel pain in your chest when you do physical activity?*
  • In the past month, have you had a chest pain when you were not doing physical activity?*
  • Do you lose balance because of dizziness or do you ever lose consciousness?*
  • Do you have bone or joint problems (for example back, knee or hip) that could be made worse by a change in your physical activity?*
  • Is your doctor currently prescribing you medication for your blood pressure or hear condition?*
  • Do you know any other reason why you should not take part in physical activity?*
  • Data Protection: We take every precaution to ensure that your details are stored safely and secured in line with our data protection policy.

    Please note we store your data in line with our GDPR Policy which can be found on our website. Your information will not be shared with any other member of staff except the Trustees governing Bushey Islamic Circle who can be contacted on info@busheyislamiccircle.org.uk and or instructors or coaches of Bushey Islamic Circle. A copy of this agreement is available on request.
  • Date & Signature

  • Today's date:*
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  • Should be Empty: