Membership Agreement

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					                                        WORKOUT 360 24/7
                                      MEMBERSHIP AGREEMENT
I.      Membership Type (please check the following)

Single: ___________      Couple: ____________          Family: ____________


II.     General Information
MEMBER ONE (MAIN):
First Name: _______________________________            Middle Name: ____________________________

Last Name: _______________________________

Date of Birth: ___________________ SSN: _________________________     DLN: ______________________

Home Address:

Cell Phone: ___________________       Home Phone: ________________ email _________________________

Workplace________________________ Work Phone: __________________

MEMBER TWO:

First Name: _______________________________       Middle Name: ____________________________

Last Name: _______________________________

Date of Birth: ___________________ SSN: _________________________     DLN: ______________________

Cell Phone: ___________________       Home Phone: ________________ email _________________________

Workplace________________________ Work Phone: __________________

MEMBER THREE:

First Name: _______________________________       Middle Name: ____________________________

Last Name: _______________________________

Date of Birth: ___________________ SSN: _________________________     DLN: ______________________

Cell Phone: ___________________       Home Phone: ________________ email _________________________

Workplace________________________ Work Phone: __________________



III.    Emergency Contact

1st Emergency Contact:   _________________________________________    Phone: ____________________

2nd Emergency Contact: _________________________________________      Phone: ____________________

3rd Emergency Contact: _________________________________________      Phone: ____________________



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IV.     Payment Authorization


          I agree to make my payments to Workout 360 24/7 through its Pre-Authorized Payment Program. I hereby authorize my bank
or credit card company to make my monthly payment for monthly dues, any unpaid past dues, and any other fees or charges from the
account I used to pay for the Total Dues today or from the account shown herein below. I understand that Workout 360 24/7 may debit
monthly dues from account.
                                                                                                  ____________

                                                                                                (Initials)



V.      Dues and Fees (to be completed by Workout 360)



Monthly Dues:                                                                  Key Fee:        $20.00

Enrollment & Security Fee:         $35.00                    Sales Tax:         8.5%

Down Payment:

PIF (3) months: ______    Silver (6) months: ______    Gold (12) months: ______    Platinum (18) months: ______



VI.     Billing Information



Cash: ______       Check: ___________       Credit Card: _________

Visa:   _______ MasterCard:     _______     American Express:    _______       Discover:   _______

Credit Card Number: ______________________________           Expiration: ____________       CSC: _________

Name of Account: ________________________________            Bank Name: ______________________________

Account Number: ________________________________             Routing Number: __________________________



VII.    Terms and Conditions



(a)     Membership will start on: _____________/___________/____________.                       ____________
                                                                                                (Initials)
(b)     First bank draft will be taken on: _____________/___________/____________.              ____________
                                                                                                (Initials)




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(c)      Payment; Insufficient Funds:        I agree to pay or designate all drafts payable to Workout 360 24/7 (hereinafter referred to
as Workout 360). I understand that Workout 360 will assess a Thirty and No/100 ($30.00) Dollars fee for any insufficient funds on
returned checks. I further authorize Workout 360 to withdraw these funds monthly, with Workout 360 being fully protected in
honoring any such draft or transfer. This authorization will remain in effect until written notice of cancellation is received by Workout
360.     Workout 360 has the right to garnish payments should the account not be paid. Workout 360 has the right to verify my
employment.
                                                                                                      ____________

                                                                                                      (Initials)
(d)       Business Hours:      I understand that Workout 360 facility is open twenty four (24) hours each day. Workout 360 shall
provide no supervision whatsoever to members at this facility after working hours. Working hours are considered to be from 7 a.m. to
8 p.m. on Mondays through Friday and 8 a.m. to 1 p.m. on Saturdays. I recognize and accept any danger involved in visiting such
facility without supervision, and I assume any such risk as explained in greater detail in the next paragraph. In case of an emergency,
please call (985) 438-2196.

                                                                                                    ____________

                                                                                                    (Initials)

(e)       Waiver of Liability; Assumption of Risk of Injury: By signing this agreement, I assume all risk of injury and I waive any and
all rights to pursue any action, of any nature whatsoever, for any harm or damage that I may suffer as a result of anything or anyone
located at the Workout 360 facility, whether it be physical or mental damage to person or property. If any injury or damage should
occur in or at Workout 360 facility, or during a Workout 360 sponsored event, I shall hold harmless and indemnify Workout 360, its
employees, representatives, agents, heirs and assigns, for any such injury or damage suffered. I further acknowledge that Workout 360
has strongly recommended that I consult with a medical physician of member=s choice prior to beginning any exercise or weight
training with Workout 360 .                                                                         ____________
                                                                                                     (Initials)

(f)       Age Requirement; Family and Guest Liability:        No person under the age of thirteen (13) is allowed in Workout 360 to use
weight equipment, cardio equipment, etc. In the event a person is between the age of thirteen (13) and seventeen (17), he or she may use
said equipment only during the office hours of 8 a.m. to 8 p.m. on Mondays through Friday and 8 a.m. to 12 p.m. on Saturdays. I
assume full responsibility for any family member on this agreement, guest or any person that I may allow access into Workout 360. I
shall be subject to a fine of If any injury or damage should occur to any such person in or at Workout 360, I shall hold harmless and
indemnify Workout 360, its employees, representatives, agents, heirs and assigns, for any such injury or damage so suffered.
Similarly, I shall be entirely responsible for any damage that such person causes to any person or property located in Workout 360
facility.
                                                                                                     ____________
                                                                                                     (Initials)




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(g)       Member Liability; Rules and Regulations: I acknowledge the existence of and the need for Rules and Regulations governing
the use of Workout 360 equipment, its facility, and the participation in programs and services. I agree to comply with all the Rules and
Regulations presently in effect or as they may hereafter be modified, amended or supplemented. Workout 360 reserves the right to
modify, amend or supplement the Rules and Regulations from time to time in its sole discretion. Workout 360 reserves the right to
cancel membership at any time for breach of these Rules and Regulations or for any undesirable behavior to be determined by the
discretion of Workout 360, and in such event, I will not be entitled to a refund of any portion of initial fees or dues paid to the date of
termination. I am prohibited from allowing anyone into the facility of Workout 360 under a member access card and such would
occur, I will be subjected to penalties, including a fine of $150.00 for initial violation and termination of membership for any subsequent
violation. In the event I should lose my member access card, I shall notify management immediately and pay a $10.00 fee for
replacement card. Furthermore, employees are not authorized to make changes to this agreement or make any independent agreement
with any member. I likewise cannot make any alterations or changes to this membership agreement. You have the right to cancel your
contract should you move 60 miles or more away. You must provide Workout 360 with proof of new residence.

                                                                                                      ____________
                                                                                                      (Initials)

(h)       Liability for Personal Property; Damage to Facility: Workout 360 shall not be liable to any member, or guest thereof, for any
personal property that is damaged, altered, lost or stolen, on or around Workout 360 facility. Personal property includes but not limited
to a vehicle and its contents or any property left in cubby. Furthermore, I shall be liable to Workout 360 for any damage to the facility,
including but not limited to equipment, furniture or fixture, located thereon, which is caused by myself, a family member, or a guest.
                                                                                                     ____________
                                                                                                     (Initials)

(i)      Parent or Legal Guardian: Any member who is under the age of eighteen (18) must have a parent or legal guardian co-sign
this Agreement. Said parent or legal guardian shall be jointly and severally liable for any and all obligations of such member hereunder
and shall be bound by all terms and conditions of this agreement.
                                                                                                      ____________

                                                                                                      (Initials)

Full Name: _________________________________                     Phone: _____________________________



I HAVE READ ALL THE TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT AND I AGREE TO BE

BOUND BY THESE TERMS AND CONDITIONS.

         THUS DONE AND SIGNED, this _____ day of ____________, 20____.



Signature:___________________________________________ Co-Signature:_______________________________________



Printed Name: ______________________________________ Printed Name: ________________________________________




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