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GARY SHIELDS
GOS ENTERPRISES DBA GOD’S GYM
2501 BROADWAY — OAKLAND — CA 94612
510.452.0409

MEMBERSHIP AGREEMENT FORM

MEMBER INFORMATION
NAME {first_name}

ADDRESS
{address}

PHONE NUMBER {phone}

TERMS

1. I AGREE to take the following Membership:
2. You are entitled to a copy of this signed Agreement (within 48 hours).
3. It is agreed and understood that the MEMBER will pay the sum herein agreed to and that there will be NO REFUNDS except expressly set forth herein.
4. In case of death, permanent disability, or resident change of 50 miles or more, MEMBER or Member’s estate shall be refunded fair payment for unused sessions. In the event of temporary disability GOD’S GYM will honor all unused sessions when MEMBER returns to the gym.
5. As a consideration for entering into this Agreement, MEMBER WARRANTS:
   1. That he/she is 18 years of age or older, MEMBERS under 18 years of age must have signed guardian consent.
   2. That he/she is NOT suffering from any physical or mental disability, and for any known reason, why his/her health should be regarded as other than normal.
   3. That he/she hereby waivers any and all claims which may arise from any injury or ailment directly or indirectly related to any physical or mental condition. MEMBER shall enter private training sessions at his/her own risks.
   4. Subsequent to this date, MEMBER specifically assumes all risks of injury while using any equipment or facilities and waives any claims against GOD’S GYM its owners or employees for any such injuries.
6. Missed workouts are forfeited. You are ONLY allowed 3 makeup workouts in a 6-week session, requiring a fee.
7. YOU THE BUYER, MAY CANCEL THIS AGREEMENT AT ANY TIME PRIOR TO MIDNIGHT OF THE 3RD BUSINESS DAY AFTER THE DATE OF THIS AGREEMENT, EXCLUDING SUNDAY AND HOLIDAYS. TO CANCEL THIS AGREEMENT MAIL OR DELIVER A SIGNED AND DATED NOTICE.

I have read the above MEMBERSHIP AGREEMENT and fully understand its contents.
I voluntarily agree to the terms and conditions stated above.

Signature:

God’s Gym: _________________________________

Date: {sign_date}

Effective Date: {sign_date}

GARY SHIELDS
GOS ENTERPRISES DBA GOD’S GYM

WAIVER AND RELEASE OF LIABILITY

Because physical exercise can be strenuous and subject to risk of injury, including serious injury, God’s Gym urges you to obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity.

You, {name}, agree that that if you engage in any physical exercise or activity or use of any gym amenity on the premises or off premises including any sponsored gym event, you do so entirely at your own risk. Likewise, dietary modifications can cause a variety of changes and can create problems, including as it relates to your energy, stamina, appetite and mood. Any recommendation for changes in diet including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility and you should consult a physician prior to undergoing any dietary or food supplement changes. You agree that you are voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness, or death. God’s Gym is also not responsible for any loss of your personal property.

This waiver and release of liability includes, without limitation, all injuries which may occur, regardless of negligence, as a result of: (a) your use of all amenities and equipment in the facility and your participation in any activity, class, program, personal training or instruction; (b) the sudden and unforeseen malfunctioning of any equipment; (c) our instruction, training, supervision, or dietary recommendations; or (d) your slipping. and/or falling while in the gym or on the gym premises, including adjacent sidewalks and parking areas This also includes any negligence associated with the presence of or transmission of any bacteria, viruses, or infectious diseases, including but not limited to Covid-19. By signing below, you acknowledge that you have carefully read this “waiver and release” and fully understand that this is a release of liability and that this release cannot be modified orally. You expressly agree to release and discharge God’s Gym and all affiliates, employees, agents, representatives, successors, or assigns, from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against God’s Gym for negligence, personal injury or property damage. You also agree that this waiver and release also applies to any guests or other participants you bring to the gym; should any such persons bring negligence, personal injury, or property damage claims against God’s Gym, you agree to defend and indemnify God’s Gyms and the hold the gym harmless to any such claims.

You further agree that if a court of law finds any part of this agreement to be against public policy or in violation of any state statute or legal precedent, then the remainder of this document will remain in full force.

Additionally, you understand that God’s Gym may occasionally photograph/video record client events/sessions and by signing below you provide your express written approval for God’s Gym to use these images or video in any and all media for promotional purposes, with no financial or other remuneration due to you.

I have read the above WAIVER AND RELEASE OF LIABILITY and fully understand its contents.

I voluntarily agree to the terms and conditions stated above.
Signature:  

GARY SHIELDS
GOS ENTERPRISES DBA GOD’S GYM

WEIGHT AND TRAINING RULES

I, {name}, member, agree to abide by all the rules listed herein.
I understand that non-compliance may result in terminated membership.

 RULES 1 - 3 are STRICTLY enforced:

1. Arrive 10 minutes before scheduled training time: Upon entry go directly upstairs to designated seating: Seats are 6 feet apart in compliance with the social distancing mandate (CDC guidelines)
2. Wear FULL finger gloves, half finger gloves are not permitted: If you don’t have full finger gloves, they can be purchased from God’s Gym for $1.00
3. Wear face mask upon entry
4. To ensure a comfortable atmosphere for everyone; I agree to be courteous and respectful of others
5. Return and rack weights when finished
6. Allow others to “work in” to take turns
7. Wear proper attire: (No cutoff shorts, sandal or thongs)
8. Bring a towel to wipe off equipment when finished
9. Swearing, grunting and yelling are distracting and offensive to others
10. Don’t drop weights on the gym floor
11. Pick up your belongings (e.g., towels, water bottles, newspaper, etc.)
12. No food or beverages (EXCEPT WATER) on the floor
13. No dating or flirting in the gym
14. No arguing
15. If you are ill, you must call in advance to replace your days
16. If you are taking a vacation, you need to pay in ADVANCE to reserve your sessions
17. We are open on holidays, unless you have been notified

I have read the above WEIGHT AND TRAINING RULES my initials are full acknowledgment and
understanding of its contents.

GARY SHIELDS
GOS ENTERPRISES DBA GOD’S GYM

PHYSICAL ACTIVITY READINESS – MEDICAL & EMERGENCY QUESTIONNAIRE

{name}

HEIGHT 
WEIGHT
DOB {dob}

DO YOU HAVE …
Any heart problems
Any chest pain
Any dizzy spells
Any back pain or limitations
Any orthopedic limitations
High blood pressure
High cholesterol
Anything not mentioned (e.g., diabetes, epilepsy, etc.)
Are you currently pregnant
Are you over 65 years of age and not use to exercise
Have you had any surgery within the last 6 months
If so, list the date(s):

If you answered YES to any of the above, please explain:
{textbox}
Are you currently under a doctor’s care?
Blood Type
If your answer is YES are there any limitations for exercising and if so, explain what they are:
 
Emergency Contact Information – 
Name {contact_name}
Phone Number {contact_phone}
Emergency contact relation {contact_relation} 

Medical Doctor’s Name

Doctor’s Phone Number

Medical Record Number