Fitness Classes Registration

Fitness Class Registration Form

Adult Fitness-FALL 2025 • Josephburg Ag Society
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Gender

FemaleMale
JAS Membership - required to register. Yearly membership expires every July 31st.*

$10 membership - purchase belowI have a current paid membership
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Adult Fitness

9:30 am - 11 am - Tuesday and ThursdayPunch Card - 10 classes
Yoga

7:00 pm - WednesdayPunch Card - 10 classes
Adult Fitness starts October 14, 2025 and runs till December 18, 2025. It is twice a week in Moyer Rec Centre from 9:30 - 11 am. 20 sessions.

Yoga IS NOT being offered this fall.

NOTIFICATION OF RISK

RELEASE AND INDEMNITY AGREEMENT: In consideration of the Josephburg Agricultural Society and Strathcona County.

I, the undersigned, on behalf of my heirs, administrators, executors, successors, and assigns hereby agree to indemnify, save harmless and release the Josephburg Agricultural Society and Strathcona County, their employees and agents, their heirs, executors, administrators or assigns of and from and against all claims of every nature and kind whatsoever which may be made by myself or any person, firm, corporation, governmental agency and from and against any liability, losses, damages or costs arising from or in any way incidental to my activities while participating in the Fitness Programs. Whether direct or indirect, consequential or otherwise.

I fully understand there is risk of injury associated with travelling to and participating in any facility exercise program or sports activity and I certify that I am in good physical condition and have no known disabilities that might otherwise be detrimental to my health or well-being.

I certify that all of the information provided on this application is correct and true.
All applicants must sign. Parents or guardians must sign if applicant is UNDER 18.

The undersigned hereby agrees to comply with the rules and regulations of the Fitness Programs, if any.
Signature*

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Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area CodePhone Number
Date Signed

MonthDayYear
Date

Freedom of Information
Photo/Video Release:

Please be advised names will not accompany any use of photos or video clips without permission. Photographs and video of large groups of participants may be posted on our website and social media without permission as long as individual participants are not singled out or identified in any way.

I hereby grant Josephburg Agricultural Society permission to the publication and use of me or my child's likeness for the purpose of promotion, publicity, advertising, or other manner or media. Likeness shall include, but not be limited to, photographs, sound and/or video recording, brochures, publications, web pages and promotional materials. I agree the actual material involved is and shall continue to be the property of Josephburg Agricultural Society and that neither I, nor my child, shall have any right of review or approval regarding the use of me or my child's likeness in such material. Names will not accompany any photos or video without written permission.
Name*

First NameLast Name
Signature*

Clear
Date Signed*

MonthDayYear
Date
My Products
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SPRING Adult Fitness - two classes/week $130.00CAD
at Moyer Rec Centre - use Hall entrance.

SPRING Adult Fitness Punch Card (10 classes)$80.00CAD

JAS Membership (required to enrol)$10.00CAD

Total $0.00CAD
Payment Methods

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Fitness Class Registration Form