Enrollment Form: Wellness 406 Gym llc

    or
    Member Details
    *
    *
    *
    *
    *
    *
    *
    Profile Photo

    Please align your face in the frame and take your photo.

    Optionally, add a profile photo.

    Address
    *
    *
    *
    *
    *
    Emergency Contact
    Billing Address
    *
    *
    *
    *
    *

    Select Membership

    Memberships Sorted Alphabetically

    [TRIAL] Day Pass

    1 day

    Unlimited

    $10.00 one-time

    Family

    ongoing

    Unlimited

    $99.95 / 28 day(s) +$60.00 one-time signup fee

    Joint

    ongoing

    Unlimited

    $69.95 / 28 day(s) +$40.00 one-time signup fee

    Joint Annual Pre-Paid

    ongoing

    Unlimited

    $840.00 / 13 month(s)

    Single

    ongoing

    Unlimited

    $39.95 / 28 day(s) +$20.00 one-time signup fee

    Single Annual Pre-Paid

    ongoing

    Unlimited

    $480.00 / 13 month(s)

    Waivers

    ASSUMPTION OF RISK OF INJURY AND WAIVER OF CLAIMS

    ASSUMPTION OF RISK OF INJURY AND WAIVER OF CLAIMS I acknowledge that Wellness 406 GYM LLC is at times an unsupervised fitness centers and there is possible danger connected with any physical activity, including the dangers of physical injury and death. I assume all risks of injury, and waive all rights to pursue money damages or any other relief of any kind, arising out of (1) my entry into or upon Wellness 406 GYM LLC; or (2) my use of any equipment, machinery, or facilities in Wellness 406 GYM LLC location or Wellness 406 GYM LLC sponsored event. On behalf of myself and my successors and assigns, I agree to indemnify and will hold harmless Wellness 406 GYM LLC and all of their owners, employees, agents, successors and assigns from and against any loss or damage that may be sustained by me or any person entering the Wellness 406 GYM LLC club as my guest. MINOR MEMBERS (if applicable) PARENT/GUARDIAN. In exchange for Club allowing my minor child to use the Club, I agree to the Assumption of Risk of Injury and Waiver of Claims clause in this Agreement on their behalf. I also agree to defend and indemnify Wellness 406 GYM LLC, all of their owners, employees, agents, successors and assigns to the fullest extent permitted by law for any claim brought by my minor child against them. I also promise to pay any financial obligation incurred by my minor child for any reason and acknowledge that the banking information on this Agreement is my account. I understand that any child of mine under the age of 16 must be accompanied by an adult at all times while in Wellness 406 GYM LLC Club. CLUB USAGE TERMS AND CONDITIONS DEFINITIONS. In this Agreement, "Club Owner" means Wellness 406 GYM LLC, "Club" means Wellness 406 GYM LLC. "I" means the person whose name and signature appear on this Agreement. USE OF CLUBS. I agree that my use of Wellness 406 GYM LLC club is subject to the terms of this agreement and any membership agreement I sign at the club. I will not allow any non-member to use my access card. I may bring a guest during staffed hours only and only after arranging for a pass with club staff. I understand and agree that I will be responsible for any claims, damages and charges made by or caused by an unauthorized guest I allow in Wellness 406 GYM LLC club. PERSONAL E-MAIL ADDRESS. I understand that I must provide a valid e-mail address to access and manage my member account online. I also will receive occasional emails from Wellness 406 GYM LLC or the Club related to my membership. I may opt-out from receiving marketing e-mails, but not emails related to my membership, through the "Unsubscribe" link included on such e-mails. PHYSICAL CONDITION AND NO MEDICAL ADVICE. I represent that I am in good physical condition and have no medical reason or impairment that might prevent me from my intended use of Wellness 406 GYM LLC facilities. I understand and acknowledge that Club Owner and Wellness 406 GYM LLC. will not and cannot provide me any medical advice. If I have any health or medical concerns now or after I join, I will discuss them with my doctor before using the facilities. RULES AND REGULATIONS. I agree to follow any club rules posted at the club or communicated by club staff. Wellness 406 GYM LLC may, in its sole discretion, modify its rules or policies without notice at any time. Club rules may vary by location. DAMAGED, LOST OR STOLEN PROPERTY. I understand that Club Owner and Wellness 406 GYM LLC are not responsible for any of my personal property that is damaged, lost or stolen while in or around Wellness 406 GYM LLC location. I understand and agree that I am liable for all damage I cause to the equipment or physical infrastructure of the club facility and will reimburse Club Owner for any damage I cause. GUESTS. I will not allow anyone besides me to use my membership access card or code, and I understand that I may be charged a $20.00 per visit fee for any unauthorized guest I allow into the Club and that my access card may be deactivated or my membership terminated and a fee will be charged to activate the card or rejoin the Club. I will also be responsible for any losses, damages or liability the Club suffers because of an unauthorized guest I allow into the Club. LIABILITY FOR PROPERTY. The Club is not liable to me or my guest for any personal property that is damaged, lost or stolen while on or around Club premises including, but not limited to, a vehicle or its contents or any property left in a locker. If I cause any damage to the Club, I am liable to Club Owner for its cost of repair or replacement. VIDEO NOTICE. I may not take unauthorized photos or videos anywhere in the Club. I understand that the Club uses unmonitored video surveillance and access card usage is logged, which both may be retained by the Club for future use PAYMENT AUTHORIZATION For purposes of this payment authorization, the term "I" refers to the person whose name appears above as the primary account holder and whose signature appears below. "You" refers to the financial institution I have identified. I authorize you to pay monthly drafts on my behalf to Club Owner (or its designee) in the amount stated at time up enrollment. These payments will continue until I submit a written notice of cancellation of my membership payment terms and pay any account balance due upon cancellation. I understand that I may continue to be billed for up to 30 days after a cancellation request. I agree that you will be fully protected in honoring these drafts and that your treatment of them and rights in respect to them are the same as if personally signed by me. I understand that I must notify the Club of account changes at least five days before my next billing cycle, and that I will incur an additional fee of $20.00 whenever my payment declines. MEMBERSHIP TERMS AND CONDITIONS DEFINITIONS. In this Agreement, "Club Owner" means Wellness 406 GYM LLC, "Club" means Wellness 406 GYM LLC. "I" and "Member" means the person whose name and signature appear on this document. Member is responsible for updating address and contact information. MEMBER'S RIGHT TO CANCEL. If I wish to cancel this Agreement, I may cancel by delivering or mailing a written notice to the Club. The notice must say that I do not wish to be bound by the Agreement and must be delivered or mailed before midnight on the third business day after I sign this agreement. The notice must be delivered or mailed to the address indicated above. If I cancel, the Club will return, within 10 days of the date on which I gave notice of cancellation, any payments I have made. All refunds will be by credit or check; there are no cash refunds. MEMBER OBLIGATIONS. This Agreement is a legally binding obligation for which I am financially responsible. If I have a prepaid or 12-month membership, I will automatically become a month-to-month member after the pre-paid or 12-month period and will be billed the then-current monthly membership rate unless I provide notice of cancellation. A 12-month membership has an early cancellation fee of $75.00. I agree not to conduct any kind of commercial or business activity in the Club and shall not act as a personal trainer for anyone within the Club. I understand I am responsible for updating my address and contact information. CANCELLATION. After my right to cancel period noted earlier (if any), I may cancel my membership by delivering or mailing written notice to the Club at least 30 days in advance of the cancellation date. All membership cancellations are effective on the last day of a month. For example, if I deliver notice on June 15th, I will pay July membership dues and my membership will terminate on July 31. If I die or become totally or permanently disabled, upon reasonable written notice to the Club with proof of the death or disability, either I or my estate may cancel this Agreement and receive a prorated refund of the unused portion of the monthly membership fees. CLUB ENHANCEMENT FEE. I understand I will be charged an annual Club Enhancement Fee up to $35 or the then current fee, at participating locations. The fee will be charged with the first billing cycle in April, provided I have been a member for at least 60 days. My use of Wellness 406 GYM LLC is subject to the terms of this Agreement. Including the assumption of risk and waiver of claims. FACILITIES AND SERVICES. The Club reserves the right at any time to delete, discontinue, repair or replace the facility equipment without any effect on this Agreement. The Club may be closed for up to two weeks each year for maintenance purposes. NO STEROIDS. I understand that the Club bans the use of steroids and I agree not to use, sell or exchange steroids on the Club's premises. LIMITATION OF LIABILITY. I agree that, unless controlling legal authority requires otherwise, any award by an arbitrator or a court is limited to actual compensatory damages. I agree that, specifically, neither an arbitrator or a court can award either party any indirect, special, incidental or consequential damages, even if one party told the other party that they might suffer these. MISCELLANEOUS. With respect to the Membership Terms and Conditions, this is the whole Agreement between the parties and supersedes any prior understandings or agreements of the parties whether written or oral, express or implied. This Agreement may not be amended or modified except in a writing signed by both parties.

    Account Password

    too short

    Credit Card
    All transactions are secure and encrypted