RFBYC Gym Membership Agreement

* indicates a required field.

Royal Freshwater Bay Yacht Club Gym Membership Agreement:

This questionnaire aims to identify those individuals with a known health condition, or signs or symptoms of a health condition, who may be at a higher risk of an adverse event during physical activity/exercise. This form is self-administered and self-evaluated.

This screening tool does not provide advice on a particular matter, nor does it substitute for advice from an appropriately qualified medical professional. No warranty of safety should result from its use. The screening system in no way guarantees against injury or death. No responsibility or liability whatsoever can be accepted by Royal Freshwater Bay Yacht Club for any loss, damage or injury that may arise from any person acting on any statement or information contained in this tool.

Please complete the questions honestly and to the best of your knowledge. Select YES or NO

APPLICANT

First Name *

Last Name *

Address

Cell Phone *

Email *

Please Provide your Emergency Contact Name *

Emergency Contact Phone Number *

Minimum Age
All Gym Members of RFBYC Gym must be a minimum of 16 years old.
All gym members between 16 and 18 years of age are deemed minors and must have a parent or legal guardian:
a) Agree to the Terms and Conditions of this Gym Membership Agreement on behalf of the minor; and
b) Sign the RFBYC Gym Parental Consent Section of this agreement before Gym Membership is approved.
By signing this agreement parents or legal guardians agree to be held responsible for any breaches by the minor of the Gym Membership Agreement and acknowledge they will be held liable for any of the consequences or penalties specified in the Agreement including suspension of their own Gym and / or Club Membership.

Parent or Legal Guardian Name (If applicant ) 18 Years old or under

Parent or Legal Guardian Contact Mobile Phone No.

DECLARATION AND CONSENT

By submitting this online form, you understand and agree to abide by the membership terms and conditions. You agree that you have completed the PAR-Q form and to the best of your knowledge all the information you have provided is true.

Parent/Legal Guardian Consent: By submitting this online form on behalf of the applicant, you acknowledge that this is a legally binding agreement and that you have read and agree to all of the provisions and terms and conditions outlined in this document and you consent to the declaration and application for Gym Membership of the applicant.