1 Year 24 Hour Access Tanning Membership 1-Year tanning membership with 24-hour 7-day access must be 18 years of age. First Name(Required)Last Name(Required)Date of Birth(Required) MM slash DD slash YYYY Email(Required) Phone(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Release Form(Required) I agreeI knowingly release and hold The Body Factory Health & Fitness Center harmless from and against all liability for loss or injury to me and/or my children resulting from our participation in all and any programs and activities. I will indemnify The Body Factory Health & Fitness Center and its employees, agents, and volunteers’ officers or directors for all costs which it or they may incur due to claims and demands alleging such loss or injury, including settlement payments, court judgments, and legal defense fees. I agree that The Body Factory Health & Fitness Center shall have final authority regarding the defense and settlement of claims or suits brought against it or its employees, agents, and volunteers, officers, or directors, claiming any such loss or injury.Gym Etiquette Rules(Required) I agreeMembers Only are allowed to enter the 24-hr access Door ● You must make sure the door is secure behind you after entering and exiting the gym. ● Each Member must swipe their card in the card reader outside or at the kiosk. Please turn off all lights and fans if you’re the last one leaving the gym. ● For hygiene purposes no sports bras alone,or Stringer tops. You must have a t-shirt, tank top, or muscle shirt. If it touches the bench it must be covered for everyone’s protection. There are disinfectant bottles throughout the gym, please wipe down your equipment after use. ● There is a cell phone or iPod charging station with space for your gym bag if needed, located by the 24-hr entrance. No gym bags allowed on the equipment area floor. ● We will not tolerate any inappropriate conduct such as loud, offensive, insulting, demeaning language, profanity, lewd conduct, or any conduct that harasses or is bothersome to members. ● Please do not monopolize machines, be courteous and allow others to work out with you. ● There is a social area up front, please do not use benches or workout areas to catch up. ● Please use the collars and safety equipment provided for you when weight lifting. There are emergency 911 necklaces available for your safety if you are working out alone. ● Insurance regulates that no one under the age of 13 is allowed in the workout area. ● ● There will be a $10.00 delinquency fee on any account with insufficient funds. ● Replacement key tag will incur a $20.00 Charge. If any member or guest violates the rules, it is our sole discretion to terminate that membership and other agreements without refund of dues.Individual 1-Year 24 Hour Access Tanning Membership Price: 1-Year tanning membership with 24-hour 7-day access must be 18 years of age.Total Coupon Code Credit Card(Required) MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name
