Membership Information Record

Online Gym Membership Sign-Up

We are 24 Hours to Our Members once Signed Up. No-Annual Fees, No-Sign Up Fees, No-Cancellation Fees. Month-to-Month Recurring Membership.
Date*

MonthDayYear
Date
Member Name*

First NameLast Name
Member Address*

Street Address

Street Address Line 2

CityState

Zip Code
Contact Information:*
Please enter a valid phone number.
Email
Birth Date:*

MonthDayYear
Date
Age
Gender*
Emergency Contact*

First NameLast Name
*
Please enter a valid phone number.
How did you hear about us?
Type of Training you are into?
Have you been a Member with us Before?*

Previously a Member (Grandfathered Rate)New Member

1. This is a member’s only gym. Please be courteous to the other members.
2. All members and guests MUST SIGN IN BEFORE WORKING OUT. If you do not sign in, you can be asked to leave by ANY member.
3. Unless arrangements are made in advance any member bringing a non-member in Central Coast Barbell will lose their membership.
4. Any person working out in Central Coast Barbell/CCB who is not a member is TRESPASSING and the Grover Beach Police will be notified.
5. Use rubber mats when using dumbbells or free weights to prevent dropping on bare floor, and prevent damaging equipment.
6. Put weights away when done. Members not putting the equipment away will not have their membership renewed.
7. If you see any member abusing the equipment ask them to stop and notify the management. Damaged or broken equipment takes time to fix or replace. YOU lose as well as the gym.
8. The front door lock combination number you have belongs to only you. Your combination number’s use is tracked by our computer. Any Members’ combination code shared to a non-current member, or an individual who has never been a member, is NOT Allowed.
9. Warning: Central Coast Barbell uses video surveillance to ensure the safety of CCB Members and Equipment.
10. It is the Member’s responsibility to keep their mailing address current.
11. If you are the last person in CCB you are required to turn off the fans, radio, lights and make sure all doors/rollup doors are closed and locked.
12. We are Recurring Payment Membership, it is Your Responsibility to Communicate request of Membership Cancellation and keep your Billing information on-file Current. We do not offer Refunds if you forget to notify us at least 7 Days prior to your Due Date. If your membership dues are not paid within 3 days after the posted date, membership will expire and your combination pulled from the door lock.
13. Use of the lockers is free. However, lockers are for the members use only while they are on the premises (unless prior arrangement has been made with the management). Any lockers found locked without the member being present will be cut open. Any property found will be turned over to the police or held in the lost and found for 60 days. After 60 days the property will be disposed of or put to use at the discretion of CCB Management.
14. No working out in bare feet or in sandals/slippers.
15. Absolutely No “BoomBox” stereos in the gym.
I agree and will follow the rules listed above: (Parent/Guardian Signature if under 18)*

Clear
Name*
Date*

MonthDayYear
Date

Agreement For Use Of Central Coast Barbell, Release Of Liability,

Acknowledgement And Assumption Of Potential Risk

IFirst and Last Name*wish to use Central Coast Barbell at 1081 Highland Way, Grover Beach, and agree to release the owners, Iron Forge Fitness, from any liability for damages incurred by me for injury, death, or damage to personal property.

I understand and acknowledge that these activities, by their very nature, pose the potential risk of serious injury/illness to individuals who participate in such activities, including but not limited to the following:
1. Sprains/ strains 2. Fractured bones 3. Unconsciousness
4. Head and/or back injuries 5. Paralysis 6. Loss of eyesight

7. Communicable diseases 8. Death

I understand and acknowledge that in order to use Central Coast Barbell, I agree to assume liability and responsibility for any and all potential risk, which may be associated with participation in such activities.

I understand, acknowledge, and agree that the owners, their employees, officers, agents, or volunteers, shall not be liable for any injury/illness suffered by me, which is incident to and or associated with preparing for and or participation in this activity.

CAUTION: Before beginning any exercise program, consult your doctor or health professional. Only he or she can establish the exercise frequency, intensity and time appropriate for your particular age and physical condition. This is especially important for people over the age of 35 and those with pre-existing health problems. Diabetics should inform gym personnel of any special needs as determined by your physician.

If you have pain or tightness in your chest, an irregular heartbeat, or shortness of breath, if you feel faint or have discomfort when you exercise, STOP! Consult your physician before continuing.
I acknowledge that I have carefully read this AGREEMENT and that I understand and agree to its term: (Parent/Guardian Signature if under 18)*

Clear
Name*
Date*

MonthDayYear
Date

Membership Option (24hr Access. Cancel Any Time, NO ENROLLMENT FEES/NO ANNUAL FEES/NO-CANCELLATION FEE) *

Month-to-Month MembershipNo Enrollment Fees/Annual Fees, Simple Month-to-Month

$55.00 for each month

3-Month Package (Reoccuring)Discounted Monthly Rate of $50/Month, for 3 months. No Contracts/No Enrollment Fee/No Annual Fee

$150.00 for each three months

6-Month Package (Reoccuring)For the Individual seeking Initiative to Commit more of themselves to Keep showing up. Discounted Monthly Rate of $48/Month. No Contracts/No Enrollment Fee/No Annual Fee

$280.00 for each six months

1-Year Member Dues$45/Month

$540.00 for each year

Total

$0.00

Credit Card

Time to Come in During Our Office Hours (4:30pm-7pm, Mon-Fri) to get your Door Code (For 24hr Access) and Meet you!
Should be Empty:

Online Gym Membership Sign-Up

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