Pink Lady Health & Fitness: Gym / Class Membership Application Form

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PINK LADY HEALTH & FITNESS

Gym / Class Membership Application Form
Please take time to read this form carefully, making sure you have completed all sections. Please make sure you have read & fully understand the club terms & conditions. The minimum age for membership is 16 unless approved by the gym manager. Please use blue or black ink and write in BLOCK CAPITALS. Please ask if you are unsure of any questions on this form.
1. Personal Details
Title Surname Home address Telephone no Email Forename(s) Date of birth D D M M Y Y
Post code:
2. Emergency contact details

Contact name Relationship Telephone no Other telephone
For use of the Gym manager only

Induction date Payment type Card done y/n Shared with Membership type Joining fees paid Membership # Account name
**PLEASE LEAVE THE ABOVE SECTION BLANK AS THIS IS FOR OUR RECORDS**
3. Membership Information
Gym Membership: entitles use of the gym facilities, off-peak 9am-5pm on-peak 5pm-9pm, you are required to undergo and induction before using the gym. Class Membership: entitles you to all of our 80+ fitness classes p/month this membership type does not include access to our gym facilities. Induction not required. Gym + Classes Membership: entitles you to use of our gym facilities and all of our fitness classes. Induction is required before you can use the gym.
Add-ons / One time fees.
Place a tick in the relevant boxes to the type of membership you would like.
Monthly Membership Individual Off Peak Individual On Peak Joint Off Peak Joint On Peak
Gym 24.99 29.99 44.99 55.99
Add classes + 9.99 + 17.99 (two people) Sunbeds (Unlimited use) + 8.99 Induction fee + 10.00
Membership Payment Method Credit / Debit Card Direct Debit Total due today: Total due next month:
Program fee + 15.00

Programs are updated every 12 weeks free of charge.
4. Membership payment options

Credit / Debit Card Credit / Debit card payments are processed securely by our card payments provider. Payments are taken every following month on the same date your membership starts. Direct Debit Direct Debit membership is set up through our bank via the Direct Debit mandate attached to this form. Payments are taken every following month on the same date your membership starts.
5. Terms & Conditions of this membership agreement

Principle Terms This agreement commences once you have indicated your acceptance into the contract. Your membership starts immediately when your first payment is received in full. You will be issued a Membership card which must be scanned each time you visit the gym / studio. Your membership card is still property of Pink Ladies Health & Fitness. You will be entitled to all rights and privileges to the type of Membership plan chosen. This agreement is for you only and cannot be transferred to anybody else. Fees & Charges Membership, induction fees & pro-rata (program) fees are collected immediately from you by us when you sign up and is NOT refundable under any circumstances unless error is made by us. Your membership payments will be made every following month on the same date you joined, each membership payment is NOT refundable under any circumstances unless error is made by us. If you lose your Membership card there is a 10 replacement fee for a new card to be issued. If any payment is not honoured on time we have the right to charge you admin fees of up to 20. Admin fees can be avoided if you let us know if you can't make a payment on your next membership due date, we may be able to change your next payment date. Membership can be frozen for 12 for a maximum of one month after which your membership will be automatically un-frozen and revert back to your monthly rate. We reserve the right to charge you for any damage to any property in the gym area caused by negligence. Membership will be terminated immediately with NO refund if you are found to be damaging property belonging to Pink Ladies Health & Fitness. There is a charge of 6 if you lose any locker keys. Cancellation of membership All monthly memberships require commitments of 3 months after which you are free to cancel. This agreement is not cancellable until all fees are paid on the length of the contract. Membership cards must be returned in good condition when cancelling your membership. Membership can be cancelled immediately by paying the remainder of the contract length. Membership may be cancelled if you become seriously ill or seriously injured a doctors note may be required as proof before we can cancel your agreement with us. If you wish to cancel your membership and pay by Credit/debit card you will need to contact us to do this. If you wish to cancel your membership and pay by Direct debit you will need to contact your bank. You must also notify us when cancelling. Personal property, Shower facilities & Car parking All personal possessions e.g. bags, phones, jewellery must be stored in our lockers provided we cannot store these for you. There is a charge of 1 to use our lockers for storage while using the gym / classes. Pink Ladies Health & Fitness take no responsibility for loss or any damage to your possessions. There is a charge of 6 if you lose your locker key. All membership types are permitted to use our shower facilities. We do not provide soap or shower gel to keep our membership costs as low as possible. Hair dryers will be provided in the wet room free of charge, Please take care of them. We ask that you please take care when using the wet room. We have our own car park that is available free of charge to all members / pay as you go. Please do not keep your car in the car park if you are not using the gym or classes.
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Club Rules You agree to comply with the rules of membership which are displayed in the club. We may make reasonable changes to these rules at any time provided that we give you notice of the changes. To keep our environment as friendly as possible we ask that you please respect all other members. Any type of violence, hatred to other members will not be tolerated and may result in termination of your membership with no refund. We have a zero tolerance rule for any racism in the premises, any member found to be racially abusive will have their membership terminated with immediate effect and banned for life from the club. We ask that you please dispose of all rubbish e.g. water bottles, sun-bed creams in the bins provided around the club. We ask that you please respect our gym equipment / shower facilities and treat them with care. All weights must be returned to their racks after use. Chewing gum and mobile phones are not permitted in the gym. Clashing weights and excessive unnecessary noises will not be tolerated. We do not provide a creche for any children, children are not allowed to wait inside the gym or outside it! Please do not use our tap water from our toilets to fill up any water bottles, this is NOT drinking water doing so could make you seriously ill and we take no responsibility for this. If you need help with anything please ask our gym staff who will be more then happy to help you! Please take all membership enquiries to the front reception do not ask any class instructors / gym trainers about your membership as only the gym manager can help with your membership enquires. We ask that you abide by these rules at all times to make our gym atmosphere friendly so you can get the most out of your membership. If we take no action or let you off any breach of this agreement or give you extra time to pay or comply it will not stop us enforcing the terms of this agreement strictly at a future date. Liability A member or visitor engaging in the club activities or making use of its facilities are responsible for ensuring that she is properly equipped and that her state of health and physical condition are such as not to involve any risk to him or herself or any other person making use of the club. It is hereby understood and agreed the club accepts no responsibility for accident, injury, illness, loss or misadventure caused to or suffered by members or guests on the club premises howsoever caused. Only to the extent caused by the wilful default or negligence of the club, its servants or agents. Members are responsible for their own insurance in respect of injuries suffered. Declaration I am aware of and understand the potential risks associated with physical exercise and I am voluntarily partaking in these activities with a knowledge thereof. I have had the opportunity to ask questions regarding activities, use of equipment, other related activities. Any questions I have asked have been answered to my satisfaction. The pre-medical screening form attached hereto has been completed to the best of my knowledge and belief. I understand that if there is a change in my condition at all, I must inform the Club Management. Without prejudice to the above, Pink Ladies Health & Fitness accepts no liability for loss or damage of whatsoever nature and howsoever arising caused to me or suffered by me whilst on the premises, UNLESS such loss or liability is caused by the negligent act of the Club. I have read, understand and accept the rules, terms and conditions laid down by the club and agree to abide by them. I understand that the club may from time to time make changes to the club without prior notice.
I have read, fully understand and agree to all of the above terms laid out in the above agreement. Customer Signature:______________________________ Date:______________________________________________ Staff Signature:____________________________________ Date:_______________________________________________
6. Recurring payments authorization

Before we can start your membership we need your authorization that we have permission to do the following: Charge your Debit/Credit card every month for the agreed amount of the membership type chosen. Charge you any outstanding amounts on your accounts or any admin fees for e.g. bounced payments. I _______________________________ have read and understand the above conditions and give my permission to automatically bill me each month for the agreed amount and any outstanding fees that my account may incur.
7. How did you hear about us?

If you were refereed by a friend or family member you are eligible for 10% discount off your membership!
Recommendation Previous visitor Website Leaflet / Flyer Driving / walking past Local radio Posters Telephone directory Local newspaper Search engine
If you were refereed by an existing member please put their name here:___________________________________________
8. Agreement confirmation (For Gym manager)

Gym Manager Signature:__________________________________________________________________________________________ Date:______________________________________________________________________________________________________________
Thank you for taking your time for reading and completing your application, we look forward to welcoming you to our gym! We are offering a FREE 1 session gym pass to your friend or family member, if you would like this voucher please ask our staff who will detach it for you.
FREE GYM PASS 1 SESSION

At Pink Ladies Health & Fitness Thank you for joining us!
Have a friend? Give them this voucher for a FREE trial at our gym! Name of Member:

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PINK LADY HEALTH & FITNESS

2. Emergency contact details

For use of the Gym manager only

Gym 24.99 29.99 44.99 55.99

Program fee + 15.00

4. Membership payment options

5. Terms & Conditions of this membership agreement

6. Recurring payments authorization

7. How did you hear about us?

8. Agreement confirmation (For Gym manager)

FREE GYM PASS 1 SESSION

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