Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

Phone

Sex

Male

Female

Occupation

How Did You Hear About Us

From a Friend/Family Member

Location

Social Media

Print Advertising

Website

Google Search

Other

Emergency Contact

Emergency Contact Name

First Name

Last Name

Phone

Medical History

Please answer yes or no to the following. Please add additional information where needed.

Heart Conditions

Yes

Diabetes

Yes

Skeletal Problems/Abnormalities

Yes

Join Injuries or Degeneration

If yes please explain:

Yes

High Cholesterol

Yes

Cancer (past or present)

If yes please explain:

Yes

Stroke or Fam. History of Stroke

If yes please explain:

Yes

Hernia

Yes

Low Blood Pressure

Yes

Epilepsy

If yes please explain:

Yes

More Information

Cardiac Risk Factors

Do you Smoke?

Yes

Do you have family history of Heart Disease?

Yes

Have you had any major surgeries in the past 12 months?

If yes please explain:

Yes

Are you taking any perscribed medication?

If yes please explain:

Yes

Are you planing on becoming pregnant in the next 8 weeks?

Yes

Exercise

Do you partake in regular exercise?

Yes

What is your daily level of activity?

What is your Short Term Goal (3mths)

Agreement - Tweak Fitness Tully 24/7

Please complete the following agreement:

Agreement Date

PARTIES:

Members Name

First Name

Last Name

Client

Liability Waiver

I, the above named new member of Tweak Fitness Tully 24/7 have read and understood the information and conditions outlined within this document.

We Can't Wait to Meet You

Will We See You This Week?

Yes

What Day Can We Expect You?

Monday

Tuesday

Wednesday

Thursday

Friday

What Time Can We Expect You

3pm-5pm

5pm-7pm

New Member Terms and Conditions

Clause (1) I understand that all new memberships of at least three (3) months duration have a cooling off period of seven (7) days only, from the date of signing this membership agreement (“Membership Agreement”), irrelevant of the start date for the membership. Requests for termination of membership and refund of any monies paid during this seven days must be presented to the fitness manager in writing. Any refunds granted with in this time will be a total of monies paid less service and administration costs. Following this period, any cancellation will be at the discretion of Tweak Fitness and if agreed to by Tweak Fitness will incur a cancellation fee equivalent to 10% of the annual membership fee at the date of this agreement. There is no cooling off period on membership renewals. I acknowledge (no response needed)

Clause (2) I understand that all direct debit memberships will roll over unless stated to Tweak Fitness management. I acknowledge (respond below)

Clause (2) Agreement

I have read and understand Clause (2)

Yes

Clause (3) 3. I understand that ‘on hold’ time may be given by Tweak Fitness management. Direct Debit members have access to 1 free week of ‘on-hold’ time per calendar year and unlimited ‘on-hold’ time thereafter for $4 per week. ‘On-hold’ time must be applied for with 7 days noticed and members must complete the online ‘On-hold Application Form’ which can be provided by Tweak Fitness staff upon request. Members with Paid in Full Memberships DO NOT have access to on-hold time. I acknowledge (no response needed)

Clause (4) 4. Early Exit/Membership Cancellation – I understand that ‘Early Exists’ can be applied to Direct Debit Memberships ONLY; Paid in Full Memberships are non-refundable. Early Exists will be processed by the following protocol and include associated fees outlined below. 6mth Direct Debit Membership - $85 instant cancelation OR 4 weeks of usual weekly payments during which time the member can continue using the facility as normal. 12mth Direct Debit Membership - $120 instant cancelation OR 6 weeks of weekly usual payments during which time the member can continue using the facility as normal. 18mth Direct Debit Membership - $150 instant cancelation OR 8 weeks of usual weekly payments during which time the member can continue using the facility as normal. To complete a cancellation members must complete an online cancellation form which can be provided by staff upon request. I understand that it’s my responsibility to complete the online cancellation application for the cancellation to be successfully processed. I understand centre management may vary any details of the direct debit agreement at any time by providing 14 days’ notice in writing. I acknowledge (no response needed)

Clause (5) I understand I may be refused entry to the centre should payment of membership fees fall into arrears, until such time as arrears have been received. I understand that additional charges may apply for late fees. I understand that prolonged non-payment of fees will result in cancellation of membership and possible legal action to recover any outstanding balance. I acknowledge (respond below)

Clause (5) Agreement

I have read and understand Clause (5)

Yes

Clause (6) I understand that centre management reserves the right to amend the hours of operation, services offered, fees and charges, and membership terms and conditions in accordance with the changing requirements of the centre. I acknowledge (no response needed)

Clause (7) I understand that appropriate clothing must be worn at all times within the centre. I understand that appropriate clothing includes a pair of closed in shoes, and that thongs and opened toed sandals are not permitted in the work out areas. I understand clothing coverage should be adequate so as not to offend other members and staff. I understand a sweat towel is a compulsory requirement of the gym. I acknowledge (no response needed)

Clause (8) I understand that the equipment is not to be modified in any way. I understand members are required to wipe down equipment, and to replace all weights and equipment following use. I understand I will be held responsible, and will be liable for any costs arising from any damage caused by myself, or any guest I bring to the premises. I acknowledge (no response needed)

Clause (9) I understand I must comply with staff recommendations and instructions regarding safe exercise performance and machine or equipment time limitations. I understand I am required to be courteous to all members and staff of the centre. I understand that no smoking, alcohol or drug use is permitted within the boundaries of the centre. I acknowledge (no response needed)

Clause (10) I understand I may be expelled from the centre for violation of any of the terms and conditions of membership, for conduct deemed detrimental to the welfare of other members or staff, or for conduct deemed detrimental to the welfare, good order and character of Tweak Fitness. I acknowledge (no response needed)

Clause (11) I hereby represent and warrant to Tweak Fitness and its directors, officers, employees, contractors, instructors, agents and affiliates (all of the foregoing are herein collectively called “workers”) that I do not have any physical , medical or other disabilities or conditions which may be affected or aggravated or result in any loss, damage or injury to my person or deterioration of my health if I make use in any way or have access to or am present at or undertake and exercise, activity or evaluation at or connected with the gym, any equipment or any of the other facilities or areas available at the centre including (but not limited to) participation in exercise activates outside the premises. I undertake to inform Tweak Fitness in writing immediately upon my becoming aware of any such disability or condition. I acknowledge (no response needed)

Clause (12) I hereby irrevocable and unconditionally release Tweak Fitness and each and all of the workers to the maximum extent permitted by law from any claim, action, suits, demands, proceedings, and causes of action and any direct, indirect, resulting or consequential loss, cost, expense or damage of whatsoever kind which I may incur suffer or sustain, whether in respect of my person or property or otherwise, arising out of or in connection with my connection with the centre or the premises, or during organised exercise outside the premises using public streets, footpaths, parks, or benches or by reason of or arising from the negligence of Tweak Fitness or any of its workers. I acknowledge (respond below)

Clause (12) Agreement

I have read and understand Clause (12)

Yes

Clause (13) I hereby acknowledged and agree that while using or having access to or present in any exercise or activity connected with the centre or the premises, my person and property are entirely at my own risk and to the maximum extent permitted by law neither Tweak Fitness nor any of its workers is liable or responsible for any direct, indirect, resulting or consequential loss, cost, expense, damage or injury to my person or property or which I may otherwise incur, sustain or suffer which is wholly or partly due to or aggravated by arises by advise, instruction, supervision, act, omission or negligence of Tweak Fitness or any of its workers or any exercise or activity or thing which I may undertake or perform or be subjected to or do using participating in or being in or at any of the facilities or by virtue of any breach or failure to comply with any rules or regulations of Tweak Fitness or the centre including those in a the Terms & Conditions Document which I acknowledge have been provided to me. I acknowledge (respond below)

Clause (13) Agreement

I have read and understand Clause (13)

Yes

Clause (14) Tweak Fitness reserves the right to select or change the billing provider for the purpose of direct billing. I acknowledge (no response needed)

Clause (15) I agree to pay: (a) Any registration fees, transfer fee or lump sum fee on signing this Membership Agreement (b) Where my membership is a direct debit membership (i) The first payment in advance to cover the initial period of time before the direct debit can be activated and the last payment in advance to cover the period of time it takes to notify the direct debit company of my cancellation. (ii) Further regular payments, to be made in advance by direct debit to us from our designated bank account, beginning on the date specified on the direct debit forms, including any fees charged by the direct debit company; (c) For all other members (i) Any administration fees or transfer fee (10% of the total annual membership cost or $95.00 whichever is the lesser) in the event of cancellation within the cooling off period; (ii) Fees for any special services that have been delivered to you prior to any accepted cancellation or non-renewal. I acknowledge (no response needed)

Agreement: I, the undersigned have read the above outlined terms and conditions specific to Tweak Fitness Tully 24/7. By completing and submitting this form I agree unconditionally to abide by the information herewith.

Name

First Name

Last Name

New Member - 24/7 Terms and Conditions

Clause (1) I the undersigned understand that Tweak Fitness is a 24 hour facility with limited staffed hours. As a member with a 24 hour access card it is my responsibility to see that card is used for my personal use only, without exception. Under no circumstance should membership access cards be shared or leant to friends or family members.

Clause (1) Agreement

I have read and understand Clause (1)

Yes

Clause (1A) In regards to access card sharing Tweak Fitness holds a strict 1 strike policy. This policy states that to become a member with 24/7 Access you need to supply Tweak Fitness with current and correct credit card details. These details will be kept securely on file. If you chose not to provide these details Tweak Fitness staff reserve the right to decline the purchase of a 24/7 Access card.

Clause (1A) Agreement

I have read and understand Clause (1A)

Yes

Clause (1B) On the first instance of an agreement breach (bringing in another person with your 24/7 access card, giving you access card to someone else to use etc) you will be charged $150 which is strictly non-refundable and be provided with a written notice of conduct befitting a Tweak Fitness member.

Clause (1B) Agreement

I have read and understand Clause (1B)

Yes

Clause (1C) On the second occasion you will be issued with written notice suspending your membership until the membership end date or time period otherwise specified by Tweak Fitness Management. After the suspended time period you can re-join as a full paying member. The said suspension period will be at full membership price without exception.

Clause (1C) Agreement

I have read and understand Clause (1C)

Yes

Members Credit Card Details (to be complete in person, in writing at Tweak Fitness Tully 24/7)

Sharing - Definition - Sharing in this context is defined as: giving another person access to the gym other than the owner of the access card. Another person is defined as anyone accessing the gym outside of reception hours alone, or accompanied by use of an access card which they do not own.

Clause (2) I the undersigned understand that Tweak Fitness will not have staff present 24 hours 7 days per week. As a result I the undersigned understand that as a member with 24/7 access to the fitness facility I will likely be using the centre without supervision of a Tweak Fitness staff member, trainer or agent. I understand that it is the requirement of each member to ensure they are as safe as possible while training in the fitness centre by taking the follow precautionary safety steps; declare any new illness/injuries to staff as they occur, do not over exert (weight training or cardiovascular), do not use machines in any other way than directed, do not use the said facility under the influence of drugs or alcohol etc.

Clause (2) Agreement

I have read and understand Clause (2)

Yes

Clause (3) Tweak Fitness Tully is fitted with a number of measures to ensure your safety at all times; - Fire alarms and extinguishers - Electronic door locking - Individualised swipe cards - Surveillance cameras – interior and exterior - Sensor lighting - Panic/duress alarm button (wall mounted and portable)

Clause (4) The emergency features of the gym namely the duress alarm and the emergency exists are to be used in emergencies ONLY. There is no exception. Members are not permitted to exit though the emergencies exits unless in the event of an emergency.

Clause (5) As you enter the gym floor the Duress alarm system is located to your right on the wall beside the entrance. The system will be pointed out to all new clients that choose to access the gym 24 hours.

Cause (6) Members will have access to a duress alarm which is wall mounted near the entry/exit point of the gym floor. In addition to the fixed location alarm a portable duress pendant that can be kept on your person during training after hours will be accessible. The theft or damage of the duress pendant will incur a $500 replacement fee. Members will incur a police enforced fine for using the duress alarm other than in the case of an emergency.

Clause (6) Agreement

I have read and understand Clause (6)

Yes

Name

First Name

Last Name

Date

Thank you for submitting your New Member Forms. Your details have now been sent to Tweak Fitness Tully 24/7 reception.

To complete your membership please drop into the gym during staffed hours:,

Monday to Friday 3pm-7pm.

Saturday: 7:00am-10:30am

A team member will assist you with payment and set up of your membership key tag and access fob.

Alternatively you can click the link below to browse our membership options and complete payment online. Once payment is complete, please drop into the gym so we can assign you a membership card or help you with the purchase of a 24/7 access fob.

Thank you for choosing Tweak Fitness and we look forward to seeing you in the gym soon.

Sincerely,

Jaydon | Tweak Fitness Managing Director