Individual Monthly Membership 1 year contract Individual Monthly Auto 1 year Membership registration First Name(Required) Last Name(Required) Social Security(Required) Date of Birth(Required) MM slash DD slash YYYY Driver's License(Required)Max. file size: 10 MB.Email(Required) Phone(Required)Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code 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 Membership - Monthly Price: Monthly auto-debit individual 12-month Membership is a 12-month non-negotiable contract. Auto-debited monthly via Credit or Debit for 24-hour membership. $74.98 for the first month and $35.99 each month thereafter.First Month Discount Price: Keytag Price: Sales Tax Price: $0.00 Total Credit Card(Required) MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name Contract Affirmation(Required) I agreeBy signing this document, I affirm that I have read and understood the terms outlined in the The Body Factory Health and Fitness Member Application. I agree to abide by those terms. I understand that this contract is legal and binding. I also understand that upon signing the contract I am obligated to the terms agreed to in the contract as well as the penalties that accompany this agreement if I am unable to fulfill these terms I am aware that monetary penalties will be added to my account and I will be subjected to collections if necessary.Signature(Required)
