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MEMBER AGREEMENT - WORLD GYM BURPENGARY

ADULT PRE-EXERCISE SCREENING TOOL

Date

Membership*

I am under 18

I am interested in physiotherapy

Price*

Term*

Start Date*

End Date*

Name*

First Last

Have you been a member of World Gym Burpengary in the past year*

Yes

Have any of your details changed in the last year?*

My Medical Circumstances Have Chanced

My Contact Information Has Changed

No All My Details Are The Same

Date of Birth*

Gender*

Male

Female

Not Specified

Mobile*

Email*

Address*

Street Address

Emergency Contact Name:*

Emergency Contact Mobile*

Membership Agreement(T&Cs)*

I agree to the following by consenting and signing below:

I agree to the following by consenting and signing below:

I acknowledge that I have been given the option of choosing a membership based on either periodic billing or pre-payment. I have chosen to pre-pay my annual membership fee.

I acknowledge that this Paid in Full Annual Membership is Non-Refundable and is not inter transferable to other World Gyms.

The Member/Buyer guarantees to pay the above membership fees for the above-mentioned minimum term. This membership does expire after the minimum term. This membership will not automatically renew, and the member will need to fill in a new membership agreement for an additional term of membership. This annual membership is not refundable and is not transferable to other World Gym Clubs. The remaining term can be transferred to a non- member with the payment of a $89 Transfer Fee.

1. USE OF FACILITIES. World Gym Burpengary hereby permits the Member, in consideration of the fees and other amounts agreed to be paid by the Member to World Gym Burpengary in this Agreement, the reasonable use of the fitness equipment, change rooms and showers, those parts of the premises designated for member use and related facilities located at 159-161 Station Road, Burpengary (collectively the “Facilities”) during World Gym Burpengary hours of operation in accordance with the terms and conditions expressed in this Agreement and the rules and regulations made by World Gym Burpengary pursuant to this Agreement in force from time to time. Membership does not include personal training, Kids World visits or other personal services, all of which are extra.

2. ADDITIONAL CHARGES. The Member shall be responsible for the following additional charges:

(A) Card Replacement Fee - $25.00
(B) Suspension Fee: $5.00 per week – which needs to be paid when completing a suspension form.

3. WARRANTY AND REPRESENTATIONS OF MEMBER. The Member represents and warrants to World Gym Burpengary (which warranties and representations the Member acknowledges World Gym Burpengary is relying upon) the following:

(A) the Member has no medical defects known to the Member and consults a qualified medical physician on a regular basis;
(B) the Member understands that he/she will be engaged in physical exercise which could, if not undertaken in a reasonable and responsible manner relative to the Member’s physical condition, result in personal injury to the Member;
(C) the Member will obey all rules and regulations of World Gym Burpengary in force from time to time;
(D) the Member will conduct himself/herself responsibly at all times and use the facilities within the physical limitations of the Member; and,
(E) the Member has read and understands the terms and conditions of this Agreement.

4. WAIVER OF LIABILITY AND DISCLAIMER BY MEMBER. The Member acknowledges and agrees that:

(A) the fees and other charges paid for membership to World Gym Burpengary are for use of the Facilities only;
(B) use of the Facilities is at the Member’s sole risk and the fees and other charges paid do not include insurance for personal injury to the Member, any damages flowing therefrom or damage or loss to Member’s property;
(C) the Member assumes all risk for personal injury, any damages resulting therefrom, any damage or loss to the Member’s property and any damages flowing therefrom howsoever caused;
(D) the Member hereby fully releases World Gym Burpengary , its shareholders, directors, officers, employees, those for which World Gym Burpengary is responsible at law or otherwise, the Landlord of the premises and any other party or parties related to any of the foregoing persons from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of the Member’s use or intended use of the Facilities, including but without limitation, any claims for personal injury arising from or as a result of the negligence of World Gym Burpengary , its owners, agents or employees or the negligence of any other person present on World Gym Burpengary premises as members;
(E) Phoenix Health Clubs Pty Ltd is fully released from any liability whatsoever or howsoever caused for any theft or damage to the Member’s person or personal property;
(F) the Member shall not make any claim or demand or commence any action against any third party who might claim contribution, indemnity or other relief over and against any person or persons referred to in clause 1(a) above;
(G) the Member shall not join, assist, and/or act in concert in manner whatsoever or howsoever with any other person, firm or corporation in making any claim or demand or the bringing of a proceeding or action in any manner whatsoever against those persons or any one or several of them set out in clause 1(a) above; and,
(H) the Member understands this Waiver of Liability, Disclaimer and Release may be raised as an estoppel and a complete bar to any demand, action, claim, proceeding or complaint made against World Gym Burpengary or any of the persons named in clause 1(a) hereof arising with respect to the matters above released and discharged.

5. OTHER TERMS AND CONDITIONS. This Agreement shall be subject to all of the other terms and conditions as set out on any attachments to this Agreement and no amendment of this Agreement shall be binding upon either party unless reduced to writing and signed by both parties.

6. RULES AND REGULATIONS. The Member agrees to abide by the Rules and Regulations attached hereto and such other rules and regulations made by World Gym Burpengary from time to time and posted in a conspicuous place on the premises.

7. MEMBERSHIP TRANSFERS. The remaining term on a PIF membership can only be transferred once to a non-member with the payment of an $89 Transfer Fee. Each. This transfer will be facilitated by the club once the existing member and the new non-member present at the Club. Member may not loan his/her membership card to anyone nor bring any non-member into the gym unless checked in at World Gym Burpengary reception.

8. BREACH OR DEFAULT OF MEMBER. Any breach or default of the Member of this Agreement shall permit World Gym Burpengary to terminate, suspend or revoke membership. Upon default in any of the scheduled payments, World Gym Burpengary may, at its option, declare the whole or any part of the balance to be immediately due and payable and the Member agrees to pay interest on the amount at the rate of 18% per annum calculated from the date of default to the date of payment. Amounts not paid in full within 10 days after their due date shall be subject to a late payment charge of 5% of the unpaid amount of the late instalment or $25.00, whichever is greater. World Gym Burpengary shall have the right, to the extent permitted by law, to enforce any one or more remedies under this Agreement whether successively or concurrently and such action shall not operate to bar or stop World Gym Burpengary from pursuing any other remedy that World Gym Burpengary may have under this Agreement or otherwise.

9. MEMBERSHIP HOLD. A member may from time to time have unique circumstances that prevent him/her from using his/her membership, such as pregnancy, prolonged travel or disability. During these times, a membership may be placed on hold status, as determined in the complete discretion of World Gym Burpengary A weekly fee may be charged while a hold is in effect. A written request must be submitted to World Gym Burpengary for consideration of Hold status.

10. LICENCE. Phoenix Health Clubs Pty Ltd is a licensee of World Gym International, LLC, is independently owned and operated, and is permitted to operate under the name “World Gym”. The Member acknowledges and agrees that the Facilities are operated solely by World Gym Burpengary and not World Gym International LLC. The Member acknowledges and agrees that neither this agreement nor use of the Facilities shall give rise to any right to bring a claim of any nature whatsoever or howsoever against World Gym International LLC and hereby releases any and all claims against World Gym International LLC that he or she now, or may in the future have, for any loss, injury or damages of any nature, whether arising under this agreement, from use of the Facilities or otherwise.

11. MEMBER’S CERTIFICATION OF UNDERSTANDING. The undersigned member certifies that:

(A) I have read, understand and agreed to the terms of this Agreement and the rules and regulations of World Gym Burpengary;
(B) I agree to abide by the rules and regulations of Phoenix Health Clubs Pty Ltd in force from time to time;
(C) I acknowledge and understand that this membership is not based on usage and that I am bound to the terms of this Agreement regardless of how often I use the Facilities;
(D) I have been advised to consult a physician before I use the Facilities;
(E) I acknowledge exercise, and in particular, weight training and aerobics, strenuous exercise may cause damage to my health and wellbeing without professional direction and my physician’s advice;
(F) The terms and conditions of membership attached form part of this Agreement;
(G) I acknowledge receipt of a true copy of this Agreement and attachments.

Signature*

Gaurantor

First and Last Name of Guarantor

Contact Number (Guarantor)

Email (Guarantor)

Relationship to the member by the Guarantor:

Guarantors Address

Same as U17

Different from U17

Guarantors Address

Medical Waive

This screening tool does not provide advice on a particular matter, nor does it subsitute 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 World Gym, Exercise and Sports Science Australia, Fitness Australia or Sports Medicine Australia for any loss, damage or injury that may arise from any person acting on any statement or information contained in this tool.

STAGE 1

AIM: To identify those individuals with a known disease, or signs or symptoms of disease, who may be at a higher risk of an adverse event during physical activity/exercise. This stage is self administered and self evaluated.

1. Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke?*

Yes

If yes - please describe:*

2. Do you ever experience unexplained pains in your chest at rest or during physical activity/exercise?*

Yes

If yes - please describe:*

3. Do you ever feel faint or have spells of dizziness during physical activity/exercise that cause you to lose balance?*

Yes

If yes - please describe:*

4. Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?*

Yes

If yes - please describe:*

5. If you have diabetes (type I or type II) have you had trouble controlling your blood glucose for the last 3 months?*

Yes

If yes - please describe:*

6. Do you have any diagnosed muscle, bone or joint problems that you have been told could be made worse by participating in physical activity/exercise?*

Yes

If yes - please describe:*

7. Do you have any other medical condition(s) that may make it dangerous for you to participate in physical activity/exercise?*

Yes

If yes - please describe:*

IF YOU ANSWERED ''YES'' to any of the 7 questions, please seek guidance from your GP or appropriate allied professional prior to undertaking physical activity/exercise

IF YOU ANSWERED ''NO'' to all the 7 questions, and you have no other concerns about your health, you may proceed to undertake light-moderate intensity physical activity/exercise.

World Gym Burpengary Rules and Regulations

Consent*

I agree to the following rules and regulations:

These Rules and Regulations are in place to ensure that we protect the rights of the members and ensure that you can achieve your results in a pleasant, motivating and non-judgemental environment.

• COVID – All members are to keep to 1.5mtrs physical distancing.
• COVID – Practice good hand hygiene, clean and disinfect your environment.
• COVID – Members are to stay at home if you unwell and / or have any symptoms of the virus.
• Members MUST sign in with their key tag on arrival
• Members must wear covered foot wear and clean respectable, gym attire. At the discretion of World Gym Management. Jeans or clothes which can tear upholstery NOT allowed. No dirty workwear allowed.
• Bags NOT permitted on gym floor.
• Towels must be used at all times when using equipment and stretch area.
• Sexual or racial harassment or harassment or intimidation of any kind will not be acceptable.
• Profanity, excessive noise, excessive grunting or yelling will not be acceptable.
• Theft or Drug Dealing of any kind will be reported to the police.
• Dropping of weights and banging machines is not allowed. Treat equipment with respect otherwise membership can be terminated.
• It is a requirement of your membership and a courtesy to others that all weights, plates, dumbbells, barbells and other equipment used, shall be returned to its rack, stand or place of origin after use.
• All members must respect the staff and other members, and be courteous of their rights and privileges while in the facility.
• Entering the facility under the influence of alcohol or drugs is strictly prohibited.
• Partaking in any illegal action or activity within the World Gym Boundaries including the car park is strictly prohibited.
• Spitting, vandalism or unruly behaviour will not be permitted.
• You are NOT permitted to bring any non-members into the Club during unstaffed hours, or let anyone else use your 24/7 key tag at any time otherwise fines and cancellation of membership will apply.
• Only World Gym licensed personal trainers are permitted to train or coach members within the Club. Anyone found doing this will be asked to leave gym immediately.
• Pin coded lockers in change rooms are only to be used for the duration of your training session. Every night the lockers will be cleaned out and items thrown away.
• Smoking including e-cigarettes is strictly prohibited in all areas of the gym.
• Certain areas will be locked and inaccessible during unstaffed hours. These include
-Sauna, Steam room & Monsoon Shower (Relaxation Area).
-Supplement Shop & Café and behind reception or any staff only area.
• Selling of supplements, foods, drinks, merchandise products by any members or staff not approved by Club Manager on World Gym Burpengary Property is strictly prohibited.
• Children or members under the age of 16 cannot use Club during unstaffed hours and they must be accompanied by an adult during normal staffed hours. All children who are not members of the gym must be admitted into Kidsworld upon entry.
• Members are solely responsible for their own belongings while training at World Gym Burpengary. Burpengary Gym Pty Ltd accepts no responsibility for any loss or damaged personal property.
• Report any broken or damaged equipment to staff at reception.

Consent*

With regard to World Gym Reformers/HIIT Membership T/C

By agreeing to participate in our classes, you agree to be bound by our Terms and Conditions set out below (Terms and Conditions).
If you do not agree with any of these Terms and Conditions, please do not participate in Reformer classes.
We reserve the right to change, update or reissue these Terms and Conditions at any time. Any such changes will be available to see our website and you agree to be bound by such changes.

1. Medical Warning
Prior to undertaking any new form of exercise, you should consult your doctor or other healthcare practitioner to ensure that you are mindful of your current health and any restrictions that may be appropriate for you.
When participating in our classes, do not over-exert yourself and work at your own pace.
Stop immediately if you feel pain or discomfort.
You should immediately seek medical attention if there are any unanticipated changes to your physical condition at any time.
You must notify your Reformer instructor if you have any pre-existing injuries or medical conditions which may impact upon your ability to perform the exercises in our classes.
By undertaking any exercise program, you acknowledge that you do so at your own risk that that the instructors will not be liable for any personal injury, loss or liability of whatsoever nature arising as a result of, or in connection with, your undertaking of any such exercise program or following advice contained on our website or given by our instructors.

2. Prices and Booking
Our current prices and timetables are displayed on our website.
To sign up to participate in our classes, you must book using the World Gym Yep Booking System. Your account will be governed by these terms and conditions, our Website Terms of Use, and our World Gym Privacy Policy.
There are a set number of bookings available in each class. To attend, you must reserve your reformer bed. Bookings can be made online or by calling reception during staffed hours.

3. Cancellation Policy
To cancel a booking, you must notify us at least 12 hours prior to the commencement of the class. Cancellations made with less than 12 hours-notice will incur a fee of $15.
Class bookings can be cancelled online by logging into your account and choosing to unreserve the class you wish to cancel, or by calling or emailing World Gym Burpengary.

4. Class Waitlists
No availability in a class? No problem! If you are unable to book a spot because the class is full, register yourself on the waitlist. When a spot becomes available, you will be notified via email and automatically booked in. Please ensure you check your email for your waitlist confirmation.
(As a courtesy, if you are no longer available to attend the class, please remove yourself from the waitlist. Once you have been confirmed in the class from the wait list, our 12-hour courtesy policy applies, and a cancellation fee will apply if cancelled within this time).

5. Class Schedules
Class Schedules are subject to change or cancellation without notice.
We are not liable in any way to provide you with a refund, credit, transfer or compensation of any kind for classes that are not held in accordance with the class schedule, including without limitation any classes that are changed or cancelled.

6. Conditions of Entry
We recommend you aim to arrive at least 5 minutes prior to the scheduled commencement time of a class. Once the class has started, your reformer may be given to someone on the waitlist.
Clients are strongly discouraged from departing classes prior to their scheduled conclusion time as it is disruptive to the enjoyment of other students attending those classes
You are required to treat all persons and property with all due care and respect.
Students are required to wear appropriate attire within the studio.
For hygiene purposes, socks must be worn at all times during your workout. A water bottle and towel is compulsory to use any World Gym equipment.
Reformer grip socks are available for purchase from reception.

7. Personal Safety and Acceptance of Risk
You must inform instructors if there are any risks to your health by participating in Reformer. You must advise your instructor of pre-existing injury, illness, muscle soreness/discomfort or are pregnant, prior to commencement. Participating in any form of exercise with a Medical Condition is done entirely at your own risk. A medical pre-screen must be completed prior to attending classes and updated at your own discretion if this changes.

8. Pregnancy
Our regular classes are safe for women to attend up to 12 weeks of pregnancy. Once pregnancy reaches 12 weeks, it is required that you stop attending the standard classes.
Specialty Pregnancy Workouts may be offered at certain times. These speciality Pregnancy Workouts are safe for women to attend throughout their entire pregnancy up to full term, if they feel comfortable to do so.
• Access to the World Gym WG30 Zone is available to members ONLY, 24 hours a day. If unauthorized members are taken into the zone, the members will be charged $20.00 on their next payment.
• During unstaffed hours, safety pendants are accessible for use. We advise to use the pendants at any time when training in this zone outside of classes times.
• Access for training to this zone is available up until 30 minutes prior to a schedule class.
• The zone is unavailable for generic training during World Gym WG30 Classes
• No equipment is to be removed from the World Gym WG30 Zone

This World Gym location is a licence of World Gym International, Inc and is independently owned and operated. FITNESS REPRESENTATION: ASSUMPTION OF RISK; RELEASE AND LIABILTY WAIVER; INDEMNIFICATION OF WORLD GYM THIS IS A LEGALLY BINDING WAIVER, RELEASE, AND INDEMNIFICATION. PLEASE READ IT CAREFULLY BEFORE SIGNING.*

I agree to the following:

In considering for my use of World Gym facilities, I hereby stipulate and agree as follows:

I realise and accept the risks of cardiovascular exercise, weight lifting, weight training and/or body building, and I am fully aware of the possibility of mechanical and/or other malfunctions of cardiovascular equipment, weight machines, and/or apparatus (“equipment”) due to the negligence of World Gym or otherwise, as well as the possibility of injury to me as a result of my or others’ use of such cardiovascular equipment, weight machines, and/or weight machines and apparatus. I fully understand and accept the serious consequences which might result due to my involvement in cardiovascular exercise and weight training and/or body building while at World Gym premises. Based on that understanding, I voluntarily assume any and all risk of, and hereby fully, unconditionally and forever release World Gym, its franchiser/licensor, and all of World Gym employees, owners, shareholders, directors, agents, independent contractors and affiliates from any loss, damage, injury or claims of any kind whatsoever that relate to my or others’ use of any and all of the equipment and facilities of World Gym.

I represent and warrant that I am in physically sound condition and I have no disability or impairment that would prevent me from engaging in active or passive exercise that would be detrimental to my health, safety or physical condition. I am in good health and have no physical conditions that would be aggravated by my involvement in cardiovascular exercise, weightlifting, weight training and/or body building, nor do I have any physical limitations that would procure such involvement. I have medical approval to proceed with a normal routine of exercise, and all exercises shall be undertaken by me at my sole risk. I understand and agree that World Gym is not responsible
for evaluating my physical condition and will not undertake
to do so.

I understand that World Gym will not provide or pay for medical and/or hospitalisation care or insurance for my benefit in the event of any injury to me occurring as a result of my being on any portion of the premises of World Gym.

I will abide by the World Gym Rules and Regulations, as they may be changed or updated from time to time in World Gym’s sole discretion. I will comply with all Rules and Regulations regarding my guests, and I will cause my guests to comply with all Rules and Regulations at any time, World Gym shall have the right, in its sole and absolute discretion at any time, to cancel my membership, and in such event I will not be entitled to a refund for any prepaid membership fees that would have been accrued for the
rest of the term.

In attending World Gym and using its facilities and equipment, I agree that I am doing so at my own risk. I understand that it is not World Gym’s responsibility to supervise my or others’ use of the equipment or facilities or conduct within or around the premises, and I understand and agree that World Gym shall not be liable or responsible for any personal injuries (including death) or property loss, theft or damage I sustain on or around the premises of World Gym, whether or not World Gym is alleged to be
negligent.

I hereby assume all responsibility for any personal injuries (including death), property loss, or property damage that I may suffer, or that I or any of my guests cause others to suffer, in connection with my, or my guest’s, use of the equipment or facilities of World Gym or my presence within or around the premises of World Gym. With Full knowledge of the consequences, i.e., that I am waiving my right to sue, I voluntarily and expressly waive and agree to unconditionally, fully and forever release World Gym and all of its employees, owners, shareholders, directors, agents, independent contractors, affiliates, successors and assigns, and its franchiser/licensor, from all liability or claims for, or relating to, any personal injury (including death), property loss, theft or property damage, tortious acts or omissions, unlawful acts or omissions, or other claims of whatever nature sustained or asserted by me in connection with my, or others’ use of World Gym equipment or facilities or my or others’ presence or conduct on or around the premises of World Gym, and notwithstanding the negligence or alleged negligence of World Gym. This release and waiver will survive my termination of membership.

I also assume full responsibility for, and agree to indemnify, defend and hold harmless World Gym and all of its employees, owners, shareholders, directors, agents, independent contractors, affiliates, successors and assigns, and its franchiser/licensor (collectively, “World Gym”), against any claims, damages, liability or expenses (including reasonable legal fees) for, any personal injury (including death), property loss, theft or damage, tortious acts or omissions, or other claims of whatever nature asserted by any other person or entity against World Gym in connection with my, or my guest’, use of the World Gym equipment or facilities or my, or my guests’, presence or conduct on or around the premises of World Gym , and notwithstanding the negligence or alleged negligence of World Gym. This indemnification will survive the termination of my membership.

I acknowledge and intend that this release and waiver of rights shall be affective not only on the date hereof, but also on all occasions subsequent hereto.

I UNDERSTAND THAT THESE PROVISIONS CONTAIN A COMPLETE AND UNCONDITIONAL WAIVER AND DISCLAIMER IN FAVOUR OF WORLD GYM. I understand that by signing below, I am waiving my right to sue World Gym (as defined above) if I suffer any injury, losses or damages of any nature whatsoever. I also understand that, by signing below, I am agreeing to indemnify World Gym and I am taking full responsibility for any claims or damages that may be made against World Gym by any other person as the result of my, or my guests’, acts or omissions within or around the premises of World Gym. This waiver, release and indemnification will survive the termination of my membership.

I acknowledge that, at times, the facility World Gym may be unsupervised, and I accept full responsibility my own actions during these times.

WORLD GYM AUSTRALIA PASSPORT MEMBERSHIP
(A) “Passport Membership”: A member can use participating World Gym clubs if they join up as a Passport Member depending on the Passport type. When a passport member joins their contract is with World Gym Australia. A Passport member pays a higher fee than a standard member which is a fixed rate set by World Gym Australia. A Passport member must join up at the club they most frequently use (“Home club”) and may use other participating World Gym clubs (“Away clubs”). World Gym Franchisees sell Passport memberships for World Gym Australia.

(B) Transfers of Passport Memberships between clubs may automatically occur from time to time. After the initial 6 months of a passport membership, if over a 3-month period a Passport Member’s visits are greater than 60% at an Away club and in-line with the World Gym Australia Passport Membership Policy, from that time that club will be designated as the Member’s Home club. This club will then be considered your HOME club and all other clubs AWAY clubs. Both the clubs and the Member will be notified once this change occurs.

First and Last Name*

ELECTRONIC SIGNATURE - I believe that to the best of my knowledge, all of the information on the Pre-Screening that I have supplied within this tool is correct. I hereby agree to abide by the above rules and regulations and report any undesireable behaviour or breachs to the above.

Signature*

I hereby acknowledge that by signing: • The information provided above my health is to the best of my knowledge correct. • I will inform you immediately if there are any changes to the information provided above.

Guarantor First and Last Name*

ELECTRONIC SIGNATURE - I believe that to the best of my knowledge, all of the information on the Pre-Screening that has been supplied in this tool is correct. I acknowledge the under 17 must abide by the rules of the gym

Signature*

I hereby acknowledge that by signing: • The information provided above for the under 17's health is to the best of my knowledge correct. • I will inform you immediately if there are any changes to the information provided above. • I understand I am Liable for any debt owing by the under 17 member

World Gym Burpengary | 159-161 Station Road, Burpengary Q 4505 | P 3053 3170 | E: reception@worldgymburpengary.com.au

Member Consultant*