Academy Health Club welcomes our newest member! #_____________
JOINING DATE:
OFFICIAL START DATE:
Name
Address
Town
Date of Birth
Home Phone
Cell/Work Phone
In case of emergency
Email
DATE INDUCTION SCHEDULED:
DATE INDUCTION PASSED:
MEMBERSHIP AGREEMENT
ACADEMY HEALTH CLUB
Berrow Road, Burnham-on-Sea Somerset, TA8 2ET
MEMBERSHIP TYPE:
FULL TIME RES GYM TEAM
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Please Circle
The undersigned, (hereinafter called “member”) acknowledges that he/she is desirous to pay for the use of the facilities of the Academy Health Club.
In consideration of the purchase of this membership, the total membership fee is payable as follows: Joining Fee £__________
First Month’s Fee £__________
Your Standing Order will be set up to deduct the amount or £_________ payable on the _______________ of each month.
Date the Standing Order will start: _____________ and continue each month, until a min notice of 14 days is given in writing to the Academy to terminate
the Standing Order.
Burnham-on-Sea Swim & Sports Academy hereby agrees to give member full use of the Academy Health Club facilities according to the membership type
indicated above, until the direct debit is stopped. Once payment has terminated, your Academy Health Club Membership has expired and all opportunities and
benefits extended to our members will expire.
RULES AND REGULATIONS
No member may use the Gym unless an induction has been passed, or the member is in an organized Strength Training Academy Class.
By tendering this application, the person whose signature appears below agrees by all rules and regulations below:
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Abuse of equipment will not be tolerated
All members are required to sign in for any classes upon entering the facility
Locks must be removed from locker following usage
Swearing and vulgarity will not be tolerated
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Equipment must be replaced after usage
Suitable clothing to be worn in the Gym. Gym shoes req’d. No bare torsos.
Any disruptive members will be subject to having membership revoked
Absolutely no alcohol, tobacco, or drugs anywhere on the premises
Member acknowledges that the Academy Health Club team has neither made claims as to medical results nor suggested medical treatment to him/her.
Member further represents that he/she is physically able to undertake any and all physical exercises and activities provided by the Academy. It is expressly
agreed that all exercises and use of all facilities shall be undertaken by member at member’s sole risk and the Academy shall not be liable for any claims,
demands, injuries, damages, actions, or cause of action whatsoever, to person or property, arising out of or connected with the use of any of the services or
facilities of the Academy, or the premises where the same are located, including those arising from the act of active or passive negligence on the part of the
Academy, its servants, agents, or employees and member does hereby expressly forever release and discharge the Academy from all such claims, demands,
injuries, damages, actions or causes of the action.
Member hereby agrees to hold the Academy Health Club, Burnham-on-Sea Swim & Sports Academy or its employees harmless from any claim or injury that
may arise, whatsoever while on the premises of the Academy. Member also understands that no representation has been made of any kind regarding one’s
ability to gain or lose weight or alter his/her health. The Academy Health Club may terminate this agreement and membership if any of the member’s
agreements are not fulfilled or Member’s representations are not correct. Member hereby understands and by acceptance of this agreement agrees, that this
membership in non-transferable to another person, non-negotiable, non-cancelable and non-refundable. Member understands that should he/she decide to
cancel membership for any reason, a 14 day notice in writing must be given. Failure to use the facility does not relieve me of my liability for payment,
regardless of circumstances.
Member recognizes that the gym, cardio room, studio & changing facilities are unsupervised at certain times and therefore the Academy recommends that
members use caution when using the Academy Health Club at all times. Member understands that he/she assumes the risk of using the Club at any hour of
the day. Member also recognizes that this is an adult only private facility. Children are not allowed into the Academy Health Club wing, unless authorized by
an Academy team member. Persons under 18 years of age must then be accompanied by a parent or guardian.
If you wish to cancel this contract, you may cancel by delivering or mailing a written notice to the Academy Health Club. The notice must say that you do not
wish to be bound by the contract and must be delivered to reception or mailed to Academy Health Club, Burnham-on-Sea Swim & Sports Academy, Berrow
Road, Burnham-on-Sea Somerset, TA8 2ET.
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Payment Details:
Joining Fee: £__________
Future Payment Type:
First Month’s Payment: £___________
o
First Payment Due: ______________
Standing Order
Form of Payment ____________ Date Paid ____________
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Type of ID
1.
2.
Monthly Payment Amount £_____________
Bank Acct. # ____________________________________ Bank Name/Routing Number ______________________________
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I, the undersigned member, acknowledge that I have read and understand the agreement.
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Member’s Signature
Witness
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Date
We look forward to helping you make
your fitness dreams become a reality!
Welcome to the Academy Health Club!