Clutch City Community Fitness Waiver
Clutch City Community Fitness recommends that you clear your participation in any exercise program with your physician.
INFORMED CONSENT/ASSUMPTION OF RISK: This release, Waiver and Hold Harmless Agreement is made by and between the undersigned (client) and Salvavietmex, LLC dba Clutch City Community Fitness, and entered into on the day, month and year noted below:
I agree to participate in one or more physical fitness program(s)/ class(es) sponsored by Clutch City Community Fitness, which may include, but not necessarily be limited to, Training, and/or strength training of any kind, subsidiary or partnership of Clutch City Community Fitness, and/or employed trainers/staff (hereinafter collectively referred to as Clutch City Community Fitness,). Clutch City Community Fitness made me fully aware that the fitness programs/classes which Clutch City Community Fitness offers and in which I desire to participate are of nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities. The client and Clutch City Community Fitness, in consideration of the above mutual agreements and promises, and in consideration of the exercise training to be provided by Clutch City Community Fitness, hereby WAIVES AND RELEASES all claims for damage or loss to person or property which may be caused by any act, or failure to act, of Clutch City Community Fitness staff, and their officers, agents, or employees. The client assumes the risk of all dangerous conditions in and around the premises and waives any and all specific notice of the existence of such conditions. The client also assumes the risk of any and all injuries that might result from participating in Clutch City Community Fitness's strength/resistance and conditioning exercise programs. I recognize and understand that the programs/classes are not without varying degrees of risk; which may include, but are not limited to: Injury to the musculoskeletal and/or cardiorespiratory systems which can result in serious injury or death, injury or death due to negligence on the part of myself, my instructor, or people around me, injury or death due to improper use or failure of equipment, or injury or death due to a medical condition, whether known or unknown by me. I am aware that any of these above-mentioned risks may result in serious injury or death. I willingly assume full responsibility for any and all risks that I am exposing myself to as a result of my participation in Clutch City Community Fitness programs/classes and accept full responsibility for any injury or death that may result from participation in any activity, class or physical fitness program. Rhabdomyolysis (hereinafter referred to as “Rhabdo”) can occur when an individual’s physical activity is so intense that muscular cells begin to breakdown and the contents and/or remaining materials enter the bloodstream. Rhabdo may be caused by many other systemic or environmental causes. However, Exertional Rhabdo can occur in athletes of all levels of fitness, resulting in muscle cell destruction. The skeletal muscle breakdown impairs kidney function as those organs are unable to handle increased enzymes that are released into the bloodstream. This induces severe physiological changes in the body. With the opportunity to fully inform myself about Rhabdo and the risks thereof, I knowingly and freely assume and accept all such risks both known and unknown. I assume full responsibility and all risks from my participation in any physical activity at the facility. I hereby certify that I have not been advised or instructed by a physician or other medical professional to refrain or limit physical activity to include the exercises or movements and physical activity of the kind to be used in strength/resistance training and conditioning as offered in the strength/resistance and conditioning program of Clutch City Community Fitness. Clutch City Community Fitness informed me that there exists the possibility of adverse physical changes during an exercise program, and I fully understand the same. Clutch City Community Fitness informed me that these changes could include abnormal blood pressure, fainting, a disorder of heart rhythm, stroke, and in very rare instances, heart attack or even death, and I fully understand the same.
In full consideration of the above-mentioned risks and hazards and in full consideration of the fact that I am willingly and voluntarily participating in the activities made available by Clutch City Community Fitness , and with my full understanding of all of the above, I hereby waive, release, remise and discharge Clutch City Community Fitness and its agents, officers, principals, and employees and volunteers, of any and all liability, claims, demands, actions or rights of action, or damages of any kind related to, arising from, or in any way connected with, my participation in Clutch City Community Fitness programs/classes, including those allegedly attributed to the negligent acts or omissions of the above-mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. I recognize that there is a risk involved in the types of activities offered by Clutch City Community Fitness. I accept financial responsibility for any injury that I or the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above-mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Clutch City Community Fitness, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by Clutch City Community Fitness.
Use of picture(s)/film/likeness: I agree to allow Clutch City Community Fitness, its agents, officers, principals, employees, and volunteers the picture(s), film, and/or likeness of me for advertising purposes, social media, or website. In the event I choose not to allow the use of the same for said purpose, I agree that I must inform Clutch City Community Fitness of this in writing.
I have fully read and fully understand the foregoing assumption of risk and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage or loss to property caused by my negligent or intentional act or omission, and with that knowledge, executes this Release, Waiver and Assumption of Risk freely and on Client’s own volition. I understand that by signing this form I am waiving valuable legal rights.
FOR MINORS ONLY: By adding a minor or minors to my account, I acknowledge that I am a parent or legal guardian of the minor(s) (client herein), and on his/her behalf, I hereby agree to all the conditions set forth above. Clutch City Community Fitness to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well-being of the child.
CLUTCH CITY COMMUNITY FITNESS TERMS & CONDITIONS
I will continue until the completion of the contract term. Late Payment of Fees: Membership fees must be paid on or before the first day of the month unless otherwise agreed upon. A late payment fee of $15 will be charged on any payment that is 5 days past due. Member may request in writing that his/her entitlement to use the Complex’s facilities under this Agreement be put on hold for one period not exceeding fourteen (14) days (a “freeze period”). By signing this agreement, the client acknowledges that the client has read, understood, and agrees with all the terms and conditions of this Agreement.
Monthly Credit Card Authorization: Client hereby authorizes Clutch City Community Fitness or its assigns to make periodic and recurring charges from the account used to pay the initial payment described above or the account entered into Client’s online account or replacement account designated by the client and accepted by Clutch City Community Fitness for payment of any and all fees, late charges, costs, expenses, or any other monies due to Clutch City Community Fitness under the terms and conditions of this Agreement. Clients understand that Client is entitled to notice of all varying charges, but Client waives the right to receive prior notice for charges made with respect to any uncollected payments or portions for the balance due described above and the corresponding service charges, both of which Client agrees are not varying charges. The client may change the account designated herein upon thirty (30) day written notice to, and approved by, Clutch City Community Fitness, Client may timely notify the financial institution in control of Client’s account to terminate this Request, but such notification will constitute a default and may cause all sums under this Agreement to be due and payable immediately together will all costs of collection to the extent permitted by law.
TERMS AND CONDITIONS
I agree that my payments will be made by recurring credit card authorizations unless otherwise negotiated in writing with management. I further agree that, unless I have provided you with prior written notice as stipulated in the Enrollment Changes or Cancellation Section of this Agreement, my enrollment options will be automatically renewed. In the absence of my providing you with a Cancellation Notice, I agree to pay the applicable fee and authorize you to debit my credit or debit card or checking account, in accordance with my prior authorization. I understand that with fourteen days prior written notice to me, you may increase your fee schedule effective as of the next Calendar Month or Term for which I become enrolled. The obligation to pay dues is not dependent on the availability of all the Clutch City Community Fitness facilities. Special engagements, repairs, and maintenance of some facilities may make it necessary for Clutch City Community Fitness to restrict the use of, or close, one or more of the facilities. Fees will not be reduced or suspended during the time when one or more of the facilities are not available.
Release: In full consideration of the above-mentioned risks and hazards and in full consideration of the fact that I am willingly and voluntarily participating in the activities made available by Clutch City Community Fitness , and with my full understanding of all of the above, I hereby waive, release, remise and discharge Clutch City Community Fitness and its agents, members, managers, officers, principals and employees and volunteers, of any and all liability, claims, demands, actions or rights of action, or damages of any kind related to, arising from, or in any way connected with any occurrence at or surrounding the Clutch City Community Fitness facilities, or my participation in Clutch City Community Fitness fitness programs/classes, including those allegedly attributed to the negligent acts or omissions of the above-mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with Clutch City Community Fitness to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well-being of the child. Indemnification: I recognize that there is risk involved in the types of activities offered by Clutch City Community Fitness . Therefore, I accept financial responsibility for any injury that I or the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above-mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify, defend, and hold harmless Clutch City Community Fitness , their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by Clutch City Community Fitness .
EFT Policy Supplement: Client must allow ten days from the date Clutch City Community Fitness s third-party billing receives EFT paperwork to process any type of change to EFT accounts.
Late Payment of Fees: Membership fees must be paid on or before the first day of the month unless otherwise agreed upon. A late payment fee of $15 will be charged on any payment that is 5 days past due. Membership may be canceled or sent to a collection’s agency at the discretion of Clutch City Community Fitness if fees are not paid on time and will not be able to rejoin unless fees are cleared.
Refunds: No refunds shall be made for services purchased, except as specifically provided in this Agreement.
Freeze Policy: Member may request in writing that his/her entitlement to use the Complex’s facilities under this Agreement be put on hold for one period not exceeding fourteen (14) days (a “freeze period”). For good cause shown by Member, and if Member is not in default under the Agreement, the Complex will extend Member’s entitlement to use the Complex’s facilities alike time as any freeze period granted. Notice of freeze must be given to Clutch City Community Fitness via email or in-person any time during business hours prior to the first day of the month to be frozen. Clients will not be billed for membership during frozen months. Member shall remain obligated to comply with the terms of this Agreement and all payments due hereunder until the effective date of termination.
Service Limitations: Clutch City Community Fitness may, at its option, terminate and/or suspend this Agreement and/or client’s participation in any program for any cause or reason, to include non-payment of fees, or if the client fails to follow Clutch City Community Fitness's membership rules and regulations or this Agreement, or for any behavior deemed by Clutch City Community Fitness's management to be harmful or inappropriate to the enjoyment, and/or participation of any other client, instructor, or trainer. Termination for any cause is effective on the date that Clutch City Community Fitness mails a written notice to the client’s last known address. The client remains financially responsible for all dues and charges incurred until the date of termination. Clutch City Community Fitness reserves the right to terminate any membership for any reason not identified in the Agreement and that is not prohibited by law. If Clutch City Community Fitness terminates a membership under this provision, Clutch City Community Fitness will mail written notice and refund any unused prepaid dues.
Cancellation: You may cancel this contract for one or more of the following reasons by delivering written notice of cancellation to Clutch City Community Fitness 8600 Westpark Dr Unit 115 Houston, TX 77063.
If a member moves his/her residence more than 20 miles (twenty) miles from the Facility, by providing proof of a change of address twenty miles from the residential location, job relocation email/letter, or military/government deployment orders.
A Member who has purchased a One-Year-Unlimited-Long membership has the right to terminate the contract for any other reason by paying the “early termination fee”. Written Notice must be given 15 days prior to the next month’s cycle or subject to next month's bill plus termination fee. The total “termination fee” is $250. If a termination notice is not received before 15 days prior to the next billing cycle client must pay next month’s membership dues plus the termination fee.
A Member who has purchased an Unlimited-Month-to-Month, Three-days-a-week-month-to-month, Three-month-special membership has the right to terminate the contract for any other reason without any “early termination fee”. Written Notice must be given 15 days prior to the next month’s cycle or subject to next month's bill. If a termination notice is not received before 15 days prior to the next billing cycle client must pay next month’s membership dues.
Damages: Client shall pay for any damages to Clutch City Community Fitness property which results from the willful or negligent behavior of member, member’s guest or dependent children.
Pictures/Video: I agree to allow Clutch City Community Fitness, its agents, officers, principals, employees, and volunteers the use of any and all picture(s), film, and/or likeness of me for advertising and teaching purposes. I also acknowledge that there are video cameras on Clutch City Community Fitness’s premises and facilities and that I will be filmed and recorded. I consent to Clutch City Community Fitness filming and recording me.
Lost Articles: Clutch City Community Fitness assumes no responsibility for lost or stolen articles. Lost and found articles not claimed will be donated to charity.
Parking: Parking is available only for the duration of the client’s workout. Clutch City Community Fitness is not responsible for theft or damage to personal property or any other injury while parked at the facility. Parking is available in the immediate vicinity of this location.
Children: The minimum age requirement for individual membership is 15years old. Parental consent is required in writing. Children age 6 to 14 years must be accompanied by a parent. Parents accompanying children must be members. Children are not allowed on the workout floor unless specifically authorized.
Change of Rules and/or Regulations: Clutch City Community Fitness reserves the right to add to, change or remove rules, conditions of membership, opening and closing hours, and the services and facilities offered by Clutch City Community Fitness from time to time.
Governing Law: The laws of Texas shall govern this Agreement. If any portion of this Agreement is held invalid or unenforceable, the remaining portions of this Agreement, if applicable, shall remain in full force and effect. This Agreement constitutes the entire Agreement between the parties; there are no collateral agreements, representations or guarantees, oral or otherwise, unless specifically written and attached hereto.
By checking the boxes and adding my electronic signature by typing my name to this agreement, the client acknowledges that the client has read, understood, and agrees with all the terms and conditions of this Agreement.
{sign_date}