Adult Month to Month

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Creed Strength & Fitness Liability Waiver (3944)
Creed Strength & Fitness Waiver and Consent Form

In consideration of my desire to engage in a strength, conditioning and fitness program at Creed Strength & Fitness, I understand and agree to the following:

Expressed Assumption of Risk
1.  Participation in any aspect of exercise and fitness is entirely voluntary.
2.  I understand that the possibility exists that certain changes may occur during exercise.  They include but are no limited to: muscular strains, sprains, joint aches, delayed onset muscle soreness, increased heart rate, abnormal blood pressure, disturbances in heart rhythm, fainting, light headiness, dizziness and very rare instance of heart attack.  I am aware that in participation I am exposed to these risks.  
3.  I am aware that there are significant risks in all aspects of physical training.  These risks include but are not limited to: falls resulting in serious injury or death, injury or death due to the negligence on the part of myself, my training partners, or others arounds me, injury or death due to improper use of equipment.
4.  I understand that at times the gym may be crowded and the nature of a gym facility involves falls due to tripping hazards, weights can be dropped accidentally on feet, smashing of fingers between weights and racks; I will conduct the activities of Creed Strength & Fitness safely and correctly.  
5.  I understand that I can minimize the risk of adverse changes and accidents occurring during training by adhering to the exercise guidelines and safety precautions.  I will follow the procedures for warming up and cooling down, cleaning up my weights, and watching my surroundings at all times.
6.  I understand that a training program of regular exercise for the heart, lungs, muscles and joints has many benefits associated with it.  These may include but are not limited to: a decrease in body fat, increase in strength, better mobility, improvements in blood pressure, heart rate and blood fats, decreased chance of injury and decrease in chance of heart disease.  
7.  For my safety, I agree to comply with Creed Strength & Fitness rules, regulations and directives including to but not limited to: those given verbally by my strength coach, via online or win writing.
8.  I, the undersigned, acknowledge that I have no physical impairments or illnesses that will endanger myself or others.   

Use of Picture(s)/Film/Likeness
1.  I do hereby grant permission to Creed Strength & Fitness to post my photo, hereinafter referred to as "Materials," that I submit to and for the Creed Strength & Fitness website, Twitter account, Instagram account and Facebook account.  
2.  I do hereby grant permission to Creed Strength & Fitness to post my photo, hereinafter referred to as "Materials," that I have been taken by my coach for the Creed Strength & Fitness website, Twitter account, Instagram account and Facebook account.  

1.  I, the undersigned, waive and release and agree to hold harmless and indemnify Creed Strength & Fitness, its employees, agents, officers and directors against any and all claims in any way connected with my participation in any and all services and programs provided by Creed Strength & Fitness.  This agreement is binding on my heirs, executors, administrators and assigns.  

I have read and understand Creed Strength & Fitness's Waiver and Consent Form
I am aware this is a contact between Creed Strength & Fitness and myself and serves as full release of liability.  I sign this release on my own free will, without coercion.  

Please answer the following questions

Adult Month to Month Contract










Emergency Contact:



This Athletic Training Program Service Agreement and Release of Liability (the “Agreement”) is between Creed Strength & Fitness and you, the Buyer (individually, as the agent(s) or guardian(s) of the Client(s), or you the Client if you are of 18 years of age). It is agreed by and between Creed Strength & Fitness and Buyer that Buyer is purchasing, for the benefit of the Client, Athletic Training Services, from Creed Strength & Fitness according to the terms on the front and reverse side of this agreement.






Monthly dues: $

Enroll/Assessment Fee: $35



First Month: $






Family: M-M/3-M/12-M

Total Down Payment: $




Prepayment – there is no payment charge applicable to this Agreement.

See the Agreement for any additional information regarding non-payment, default, and penalties.

PAYMENT SCHEDULE: ____ payments of $______ are due on the  ______ of each month beginning ______________, 20____


I(We) hereby authorize Creed Strength & Fitness hereinafter called COMPANY, to initiate debit entries, and corrections thereto, to my(our) Checking, Savings or Charge Card account indicated below and the depository or credit card named below, hereinafter called DEPOSITORY. 

BANK NAME OR CARD TYPE:_________________________________CREDIT CARD EXPIRATION DATE:____________

ACCOUNT NO. (CC # or Bank Acct #):_________________________________________3 DIG SECURITY CODE:________

BANK BRANCH:___________________________ADDRESS:___________________________________________________

BANK TRANSIT/ABA(Routing) NO:_______________________________ACCOUNT NO:____________________________

This authority is to remain in full force and effect until COMPANY and DEPOSITORY have received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it, or until all payments due under the contract have been made.  This will be a minimum of 30 day notice.  

NAME(S)_____________________________________________CONTRACT NUMBER______________________

DATE__________________SIGNED x____________________________SIGNED x______________________________

IMPORTANT NOTE: Buyer on his or her behalf, or as agent or guardian for a client identified above who will use the Athletic Training Program services purchased under this agreement (as used herein, in individually and collectively, “buyer”), signing and agreeing to partake in COMPANY from liability due to participation. Buyer is urged to have this release agreement reviewed by an attorney before signing.

By signing this Agreement, Buyer acknowledges that Buyer has read, understood and agreed with all terms and conditions of this agreement, which includes the E.F.T. Request and Authorization, the Release and Waiver of Liability, and all Additional Terms and Provisions located on the front and reverse side of the Agreement. This agreement constitutes the entire agreement of the parties and no other agreement or understanding exists between Buyer and COMPANY has made no express or implied warranties or misrepresentations other than those expressly set forth in this Agreement to induce Buyer to enter into this Agreement. Any conflict between the original Agreement and any copy of the original Agreement shall be controlled by the original Agreement.

Note of Autorenewal:  I understand that unless I submit a notice of written cancellation within 30 days of the last scheduled E.F.T. payment as described in the “Payment Schedule” section above, this contract will automatically convert to a month-to-month agreement, whereby I will continue to purchase a month-month membership for a monthly payment of $___as indicated in the “Program Fees” section above. I understand that, except as allowed by this contract or applicable state law, this agreement is non-cancelable during the initial term, but that, upon conversion to a month-to-month agreement, the agreement may be cancelled at any time by submitting a 30-day written notice of cancellation to the address indicated in this contract.

Initial ___________

Notice to Customer: You may cancel this agreement any time before midnight of the third business day after the date of this agreement. To cancel this agreement, you must notify the seller in writing no later than midnight of _______/_______/_______

Executed at (Facility Address)__________________________________________Dated:_________________/__________/___

                                          Street Address         City      State                 Zip

__________________________________                                       ___________________________________________

Representative Signature                                                            Buyer’s Signature/Client’s Signature