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*Fill out 1 application per membership. All members on membership must to fill out a waiver*

Membership Application

Please select an appropriate membership category and complete the membership application below. Junior membership is only eligible for under the age of 25.

Membership Type:

MEMBERSHIP INFORMATION:

Primary Adult: (Responsible for account)

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Membership Application

Please select an appropriate membership category and complete the membership application below. Junior membership is only eligible for under the age of 25.

Membership Type:

MEMBERSHIP INFORMATION:

Primary Adult: (Responsible for account)

Secondary Adult:

Children:

All dues and fees are subject to sales tax. In the event that Member’s account remains unpaid for 60 days after the billing date, the West Village Athletic Club shall have the right at any time thereafter to charge the account provided therefore, without any further authorization or signature of Member. Member understands that it is Member’s responsibility to keep a valid authorized account or credit card on file with the West Village Athletic Club at all times and to inform West Village Athletic Club of a change in the particular credit card to be charged. Upon termination or expulsion of membership, Member authorizes the West Village Athletic Club to charge the account or credit card provided for the outstanding balance on Member’s account, without any further authorization or signature of Member. Member understands that they can never be assessed as a matter of contract with the West Village Athletic Club and that it is further understood and agreed that Member assumes no liabilities in connection with membership other than sums set out above and charges incurred through use of the West Village Athletic Club. Member agrees to conform to and be bound by rules and regulations of West Village Athletic Club. Member understands that these are subject to change and that violation of regulations may result in termination of West Village Athletic Club privileges. I understand that any exercise program I undertake may create physical stress and subsequent harmful effects. I agree that it is solely my responsibility and not the responsibility of the West Village Athletic Club to request me to consult with a physician prior to commencing any exercise program, to remain under medical supervision that is indicated, and to seek medical assistance in the event of an injury. I recognize that the use of the equipment entails some risk of accidental injury to myself and to others and agree that I will use such equipment and facilities with due care. West Village Athletic Club and its owners, employees, and agents assume no liability for persons who undertake physical activity. Every Member, family member, and guest using the Club’s facilities does so at his or her own risk, and the West Village Athletic Club is not responsible for any injuries occurring to such persons. All Members, family members, and their guests expressly hold harmless, waive, and release the West Village Athletic Club from any and all claims relation to or arising out of their use of the West Village Athletic Club’s facilities.

Membership is non-transferable. Initiation Fee is non-refundable. Upgrades in Membership type will result in additional Initiation Fee. Resignation is required in writing and takes effect after 30 days.

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WAIVER & RELEASE FORM

Assumption of Risk for Participation in Personal Training/Gym Use/Fitness Classes

Each client/member of West Village Athletic Club should realize that there are substantial risks, hazards, and danger inherent in such programs. Each participant involved in Personal Training/Gym Use/Fitness Classes must be covered by an accident and health insurance policy. It is the responsibility of each participant to participate only in those activities for which he/she has the prerequisite skills, qualifications, preparation, and training. West Village Athletic Club does not warrant or guarantee in any respect the physical condition or any equipment used in connection with the activity. Therefore, in consideration of the benefits received from Personal Training/Gym Use/Fitness Classes, the undersigned assumes all risks of damages or injury, including death that may be sustained by him/her while participating in an exercise activity or in travel to or from such activity.

Release, Covenant Not to Sue, and Waiver

Personal Training/Gym Use/Fitness Classes involves an inherent risk of physical injury; the undersigned assumes all such risks. The undersigned agrees and understands that this is an intermittently unmanned gym. It is recommended to have a work out partner present at all times while working out.

 

The undersigned hereby agrees that for the sole consideration of West Village Athletic Club allowing the undersigned to participate in Personal Training/Gym Use/Fitness Classes for which or in connection with which West Village Athletic Club has made available any equipment, facilities, grounds, or personnel for such training, the undersigned does hereby release, covenant not to sue, and forever discharge West Village Athletic Club and officers, agents, contractors and employees of any and for all claims, demands, rights, and causes of action of whatever kind or nature including but not limited to negligence, unforeseen bodily and personal injuries, damage to property, and the consequences thereof resulting from participation in any way connected with such recreational programs and activities. Undersigned agrees not to hold West Village Athletic Club or its owners/employees responsible for any crime committed against while on the property of West Village Athletic Club. The undersigned understands that this Release, Covenant Not to Sue, Waiver, and Assumption of Risk shall be effective from the date of signature until the effective termination of the Personal Training/Gym Use/Fitness Class services by West Village Athletic Club.

 

By signing this document, the undersigned hereby acknowledges that he/she has read the above carefully before signing, and agrees to comply with all the above.

Physical Activity Readiness Questionnaire (PAR-Q)

Regular physical activity is fun and healthy, and increasingly more people are starting to become more active everyday. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming more physically active.

 

If you are planning to become more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 13 and 69 the PAR-Q will help you decide if you should check with your doctor before you start. Even if you answer NO to all of the PAR-Q questions below, however, it may still be a good idea for you to check with your doctor before you start. And if you are over 69 years of age, and you are not used to being very active, you should check with your doctor.

Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly.

Check YES or NO:

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?
Do you know of any other reason why you should not do physical activity?

If you answered YES to one or more questions:

If you answered No to all questions:

Talk to your doctor by phone or in person BEFORE you start becoming more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.

  • You may be able to do any activity your want – as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those that are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.

  • Find out which programs are safe and helpful for you

If you answered NO honestly to all PAR-Q questions, you may decide that you are ready to:

  • Start becoming more physically active – begin slowly and build up gradually. This is the safest and easiest way to go.

  • Take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively.

But even if you answered NO to all of the questions, it may still be a good idea for you to check with your doctor before becoming more physically active.

Delay becoming more active:

  • If you are not feeling well because of a temporary illness such as a cold or a fever-wait until you feel better, or

  • If you are or may be pregnant – talk to your doctor before you start becoming more active

Please Note: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

If you are or may be pregnant – talk to your doctor before you start becoming more active

Informed use of the PAR-Q: The West Village Athletic Club and its owners, employees, and agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity. I understand that any exercise program I undertake may create physical stress and subsequent harmful effects. I agree that it is solely my responsibility and not the responsibility of the Club to request me to consult with a physician prior to commencing any exercise program, to remain under medical supervision is that is indicated, and to seek medical assistance in the event of an injury. I recognize that the use of the equipment entails some risk of accidental injury to myself and to others and agree that I will use such equipment and facilities with due care. Every Member, family member, and guest using the Club's facilities does so at his or her own risk, and the Club is not responsible for any injuries occurring to such persons. All Members, family members, and their guests expressly hold harmless, waive, and release the Club from any and all claims relating to or arising out of their use of the Club's facilities.

I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.

Thanks for submitting!

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