Group Fitness Plan Form printable pdf download

Revised 9/10

GROUP FITNESS PLAN FORM

$ 40.00 = 10 Classes APR

Offer Expires

$ 50.00 = 10 Classes Reg.

SIX MONTHS From

$ 80.00 = 22 Classes APR

Date of Purchase

$100.00 = 22 Classes Reg.

Name

Daytime Phone

Evening Phone

Address

City

Zip

Emergency Contact

Phone

PARTICIPATION INFORMATION

This form expires – SIX MONTHS from the Date of Purchase.

Initial

Class participants must check in at the front desk no earlier than 15 minutes prior to each class.

Admittance into the Community Center is for class only. Use of other activity areas is not included.

There shall be no Refund for the Group Fitness “Value Flex” purchase.

NOT GOOD FOR REGISTERED YOGA Class.

I understand that this program involves certain activities that could cause serious personal injury. I personally and completely

assume all risks and hazards on behalf of myself and/or my children incidental to the conduct of the activities, practice

sessions and transportation to and from such activities. I do further hereby release, indemnify, and hold harmless the City of

Lapeer, its Boards and Commissions, employees, agents, and representatives of either, from any claims or lawsuits arising

from, or related to the activities, premises, conditions and equipment used, in connection with my participation. I represent

that I am aware of the physical demands of this activity and that I/my children are sufficiently physically fit to participate in the

activities. My signature below indicates that I have read and understand the conditions of my/my children’s participation.

Participant’s Signature

Date

FEE__________RECEIPT #___________________ Cash_____Check_____Charge_____Staff____________Date____________

Select

Rec #