Fitness Center Membership Application

* Indicates required field

Name *

First

Last

Street Address *

Postal/Zip Code *

City *

State *

Email *

Phone Number *

Demographics

Emergency Contact

First Name *

Last Name *

Relationship *

Phone Number *

I have read, understand, and agree to all the information on the back of this. I further expressly agree that the assumption of risk, release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the state of Illinois and if any portion thereof is held invalid, it is agreed that the balance shall, not withstanding, continue in full legal force and effect. I also understand and agree that if the membership is interruption any reason these agreements will remain in effect during the period of interruption as well as after the membership is reinstated.

Client E-Signature *

Date *

Photo and Video Release

I hereby grant permission to Claretian Associates, the rights to my image, in video or still, and the likeness and sound of my voice as recorded on audio or video. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product where my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording.

By signing this release, I acknowledge that I have completely read and fully understand the above release. I hereby release any and all claims against any person or organization utilizing this material for educational purposes.

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Fitness Liability

I am aware of my own health and physical condition and have knowledge that my participation in any exercise program may be injurious to my health. I am voluntarily participating in a physical program.
Having such knowledge, I hereby acknowledge this release and Claretian Associates will not be liable for any accidental injury or illness which I may incur because of participating in any fitness physical program. I hereby assume all the risks connected therewith and consent to participate in the physical program.

I agree to disclose any physical limitations, disabilities, or impairments which may affect my ability to participate in this fitness.

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Privacy Policy

Claretian Associates will never disclose any personal information collected through the course of business with any third parties except when deemed necessary to fulfill a specific request or obligation to you or to comply with a valid legal process.

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Cancellation Policy

As a member of the SALUD Fitness Center, you can cancel your membership at any time by giving the SALUD Center a minimum of 5 business days notice prior to the next billing cycle. The cancellation may be made in person. We cannot refund the prepaid portion of your membership.

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