PHYSIQUE PRO GYM WELLNESS CENTER

MONTH TO MONTH MEMBERSHIP

**THIS MONTH TO MONTH MEMBERSHIP CAN BE CANCELLED AT
ANYTIME, NO CANCELLATION FEES ADDED

MEMBERSHIP DETAILS:
Todays Date: ______________
First Name: ___________________ Last Name: ___________________
Sex: Male Female

Birth Date: ___/___/___

Mailing Address:
__________________________________________________________
City: ___________________

State: __________

Zip Code: _______

Telephone: __________________ Email: _______________________

Terms of Membership: All memberships of Physique Pro Gym & Wellness Center are monthto-month, Automatic debit/credit, cash withdraws will only be cancelled within 48hrs of Written
Notification by the current Physique Pro Gym Member. No refunds will apply.
**All Memberships except our Military Service Members & Seniors 60yrs & older have a
Yearly $25 Maintenance Fee Added in June or December depending on when you signed up
for your membership: if you sign up for a membership between January-May your Maintenance
Fee is taking out in June, if you sign up for a membership between July-November your
Maintenance Fee is taking out in December this is for wear and tear of all our equipment.
Cancellation of Membership at any times no charge to member.
DEFAULT/REMEDIES: Any monthly payment received more than five (5) days after the due
date will automatically be placed on HOLD or membership will be revoked at the discretion of
the GM or Owner of Physique Pro Gym.
FACILITY AND HOURS OF OPERATION: With the exception of any closures for
maintenance or any mandatory shutdowns by property management or any governmental
authority, gym is open seven days a week, three hundred sixty-five (365) days a year. Gym
hours are MondayFriday 4am-10pm, Saturday & Sunday 5am5pm.
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1. In consideration of being allowed to participate in the fitness training activities and programs
of PHYSIQUE PRO GYM & WELLNESS CENTER and to use its facilities, equipment and
services, in addition to the payment of any fee or charge. I agree to voluntarily give up and or
forever waive any rights that I may otherwise have to bring a legal action and or lawsuit to any
City/County/State/Federal Court(s) within the State of Colorado against PHYSIQUE PRO
GYM & WELLNESS CENTER or its employees, sub-contractors for personal injury or
property damage. I do hereby forever waive, release and discharge PHYSIQUE PRO GYM &
WELLNESS CENTER and its officers, agents, employees, representatives, sub-contractors,
executors and all others acting on their behalf from any and all claims or liabilities for injuries or
damages to my person and/or property, including those caused by the negligent act or omission
of any of those mentioned or others acting on their behalf, arising out of or connected with my
participation in any activities, programs or services of . PHYSIQUE PRO GYM &
WELLNESS CENTER (PLEASE INITIAL: _______)
2. I have been informed of, understand and am aware that strength, flexibility and aerobic
exercise, including the use of equipment, is a potentially hazardous activity. I also have been
informed of, understand and am aware that fitness activities involve a risk of injury, including a
remote risk of death or serious disability, and that I am voluntarily participating in these activities
and using equipment and machinery with full knowledge, understanding and appreciation of the
dangers involved. I hereby agree to expressly assume and accept any and all risks of injury or
death. (PLEASE INITIAL: ________)
3. I do hereby further declare myself to be physically sound and suffering from no condition,
impairment, disease, infirmity or other illness that would prevent my participation in these
activities or use of equipment or machinery. I do hereby acknowledge that I have been informed
of the need for a physicians approval for my participation in the exercise activities, programs
and use of exercise equipment. I also acknowledge that it has been recommended that I have a
yearly or more frequent physical examination and consultation with my physician as to physical
activity, exercise and use of exercise equipment. I acknowledge that either I have had a physical
examination and have been given my physicians permission to participate or I have decided to
participate in the exercise activities, programs and use of equipment without the approval of my
physician and do hereby assume all responsibility for my participation in said activities,
programs and use of equipment. (PLEASE INITIAL: _________)
4. I desire to engage voluntarily in a weight training\aerobic exercise program given at
PHYSIQUE PRO GYM & WELLNESS CENTER in Denver, Colorado. I understand that the
activities are designed to place a gradually increasing workload on the body in order to improve
overall fitness. I understand that I am responsible for monitoring my own condition throughout
my workouts and should any unusual symptoms occur, I will cease my participation and inform
the staff of the symptoms. (PLEASE INITIAL: _________)
5. Member/Members Indemnify and hold harmless PHYSIQUE PRO GYM & WELLNESS
CENTER their elected and appointed officials, sub-contractors, employees, students, agents, and
volunteers, from any and all liabilities or claims made by other individuals or entities as a result
of or relating to my participation in this activity. (PLEASE INITIAL: _________)
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6. Member/Members in signing this consent form, I affirm that I have read, accept and
understand this form in its entirety and that I understand the nature of exercise. I know that there
may be risks associated with weight training and fitness classes and willingly accept those
possibilities. I know that it is my responsibility to ensure my own safety. I take full responsibility
for my own health and safety in participating in weight training or the fitness class and to the
extent I deem advisable, will consult a physician before participating in any of the activities. I
agree to pay all reasonable costs related to weight training or the fitness classes, including any
medical costs I incur. I agree to voluntarily give up and or waive any rights that I may otherwise
have to bring a legal action and or lawsuit to any City/County/State/Federal Court(s) within the
State of Colorado against PHYSIQUE PRO GYM & WELLNESS CENTER or its employees,
sub-contractors for personal injury or property damage. Member has not been coerced into this
Gym Membership and is signing this Gym Membership of his/her own free will.
Signature:_____________________________________________ Date:__________________
****If Applicant is under 18 years of age, Signature of Parent or Legal Guardian:
I hereby consent to my childs physical activity as described above. I acknowledge that I have
carefully read this Waiver and Release and fully understand that it is a release of liability on
behalf of myself and my child, I expressly release and discharge PHYSIQUE PRO GYM &
WELLNESS CENTER and all employees, agents, sub-contractors, representatives, successors,
or assigns, from any and all claims or causes of action, and I agree to voluntarily give up or
waive any right that my child or I may otherwise have to bring a legal action against
PHYSIQUE PRO GYM & WELLNESS CENTER or its employees, sub-contractors for
personal injury or property damage.
_____________________________________________________________________________________
Parent/Legal Guardian
Date

**PERSONAL TRAINING:
PHYSIQUE PRO GYM & WELLNESS CENTER offers no personal training. Should
Member wish to make arrangements for personal training with one of our Certified Independent
Personal Trainers, such arrangement shall be solely and exclusively between Member and the
trainer. PHYSIQUE PRO GYM & WELLNESS CENTER is not a party to any arrangement
between members of PHYSIQUE PRO GYM & WELLNESS CENTER for personal training.
PHYSIQUE PRO GYM & WELLNESS CENTER shall not be liable in any way for results or
lack of results obtained from any personal training arrangement activities between its members.
All releases and waivers of liability as outlined in Sections 1&5 herein apply to any and all
fitness activities in which Member engages, regardless of any arrangement between members for
personal training. Any introduction(s) by PHYSIQUE PRO GYM & WELLNESS CENTER
of a member who is a personal trainer to Member shall not be considered by Member to be an
endorsement of the trainer by PHYSIQUE PRO GYM & WELLNESS CENTER. No member
of PHYSIQUE PRO GYM & WELLNESS CENTER who is a personal trainer shall represent
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himself or herself to be an employee or an affiliate of PHYSIQUE PRO GYM & WELLNESS

CENTER in any way other than as a member of the Facility. No member may use the
PHYSIQUE PRO GYM & WELLNESS CENTER name or logo for any purpose. (PLEASE
INITIAL: _________)

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Members Terms & Conditions

1. Appropriate covered footwear/socks/shirt/tank top must be worn at all
times while in the gym facility. **No Sandals or Uncovered Footwear
which exposes foot or toes allowed due to high risk of serious injury**.
2. Memberships are only refundable and transferable at the discretion of
the GM or Owner of Physique Pro Gym.
3. **All Weights and Equipment must be put back after Full Use!!! (THIS
IS APPROPRIATE GYM ETIQUETTE) for all Gym Members, this is a
huge problem for Men in most gyms. Any member caught not putting
back his/her weight equipment will be given one verbal warning. The
second verbal warning will result in Membership being Revoked!!!!!***
4. **All equipment shall be wiped down by Member after each use, with
the supplies provided by Physique Pro Gym.
5. Under no circumstances shall Member move exercise equipment or use
the equipment in any manner not authorized by Physique Pro Gym.
6. This membership is for Member and Member only and Member will not
give access to another individual.
7. Member will not misuse or abuse the cardio/free weight equipment.
8. Physique Pro Gym shall not be responsible for any lost or stolen items.
9. Members will not occupy any equipment for an extended period of time
making other members wait for use of said equipment. Members will
allow other members waiting to use such equipment to work into their
rotation!!!!!
10.Shared gym access with a non-member will result in forfeiture of
membership effective immediately.
11.Use of Video Equipment is allowed in Physique Pro Gym for the
purpose of promoting cardio/weight training in social media platforms.
12.Each member must respect other gym members/users and behave in an
appropriate manner at all times. No foul and or inappropriate language
is allowed or used in Physique Pro Gym.
13.Children under the age of 13yrs old are not allowed on any of the
Cardio Machines or in the Weight Training area unsupervised by their
parent/legal guardian or repersentative, this is for their own safety.
14.Automatic Renewals on all Memberships unless member cancels.
15. Physique Pro Gym Staff/Trainers have the right to revoke the
membership of any member(s) not complying with the terms and
conditions of their membership.
PLEASE SIGN:__________________________________
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Physique Pro Gym & Wellness Center

Fitness/Health/Wellness Screening Questionnaire
Date:___________________________ Email:_____________________________
Name:___________________________________________
Address:_________________________________ City______________________
Phone:____________________
__________________________________________________________________
What are you goals? (Circle all that apply)
Weight Loss/Toning Muscle Gain Strength Flexibility General Health/Maintenance

Tell Physique Pro Gym & Wellness Center more about your Goals:________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
How long have you been thinking about making a Positive Life Style Change
to your overall Fitness & Health? 0-3Months 3-6Months 6+Month
On a scale of 1-10 How important is it to reach your overall Fitness & Health
Goals: 1 2 3 4 5 6 7 8 9 10
How active are you now and what is your overall life style regarding Fitness &
Health? (Circle all that apply) Sedentary Moderate Exercise Competitive Exercise
Have you started an exercise program before? Yes or No
Did you reached your desired Fitness goals? Yes or No
Are you interested in Personal Training? Yes or No
Would you like to have a Personal Trainer contact you regarding Personal
Training? Yes or No
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