Signup

• {first_name} - First name
• {name} - Full name
• {dob} - Date of birth
• {address} - Member address
• {phone} - Phone number
• {contact_name} - Emergency contact (if member has any)
• {contact_phone} - Emergency contact phone
• {contact_relation} - Emergency contact relation
• {sign_date} - Date document was signed (if applicable)

Please complete this application in order to obtain access to Lifting Up Fitness.  By completing this application, you are releasing all liability from Lifting Up Fitness (Lifting Up LLC).  You are agreeing to abide by all gym rules and regulations.   When accepted by the Lifting Up Fitness representative, this application shall constitute a binding contract between the applicant(s) and Lifting Up Fitness by which they mutually agree to the terms and conditions contained herein and to such other terms and conditions as may be incorporated herein by reference.  Your initial/signature (digital or written) below constitutes acceptance of all rules and regulations as stated above and below.

• {first_name} - First name
• {name} - Full name
• {dob} - Date of birth
• {address} - Member address
• {phone} - Phone number
• {contact_name} - Emergency contact (if member has any)
• {contact_phone} - Emergency contact phone
• {contact_relation} - Emergency contact relation
• {sign_date} - Date document was signed (if applicable)

I have been informed by the staff of Lifting Up Fitness of the ability to access the gym during non-staffed hours. I realize that while working out during non-staffed hours, as well as staffed hours, I will be exercising at my own risk.  I accept complete responsibility for my health and well-being in this voluntary fitness program and understand that no responsibility is assumed by the leaders of the program or sponsoring agency. 

I have been informed of the requirements for use of the facility after staffed hours and have been made aware of the location of  cameras, and other safety features available to me. I have been informed of what actions to take during an emergency. 

It is expressly agreed that all use of the facilities shall be undertaken by me at my sole risk, and the seller shall not be liable for any injuries or damage to any member or guest, or the property of any member or guest, or be subject to claim, demand, or damages whatever, including without limitations, those damages resulting from acts of active or passive negligence on the part of the seller.

I agree to allow Lifting Up Fitness to keep a picture of me on file for future reference.

I understand that Lifting Up Fitness will hold me responsible for any damages to the facility or equipment that is done by horseplay or intentional destructive behavior.

I understand that I am never to loan my access key to another individual or allow members or non-members to access the facility using my personal entry device.  While using the facility I agree to never allow entry to another individual, member or not. I understand that individuals under the age of 18 and any guests are not allowed during non-staffed hours. 

I understand that a violation of these rules and policies can result in the immediate termination of my membership. 

• {first_name} 
• {name} 
• {dob} 
• {address} 
• {phone} 
• {contact_name} 
• {contact_phone}
• {contact_relation}
• {sign_date}
• - A box the member can optionally check

By checking the box above I grant permission for my children to access the lifting up fitness gym and waive all liability.

I authorize my child to use the exercise equipment including but not limited to universal gym, treadmill, elliptical machine, recumbent bike, exercise bike weight bench, leg lift, leg press machine, lat/row machine, multi-press machine, free weights, etc. as well as to participate in group fitness classes.

I specifically acknowledge that Lifting Up Fitness does not assume responsibility for any injury or the results of any injury during the use of the said equipment or the facilities at Lifting Up Fitness. 

In the event that any injury occurs during the use of the equipment, I assume financial responsibility for all medical/dental services rendered. I furthermore release Lifting Up Fitness from any liability in the event of injury to my child while participating in any above mentioned activity at Lifting Up Fitness.  I have carefully read this release and fully understand its contents.

This authorization remains in effect from the date below until by child is 18.

Child’s Name -

• - Required text input

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