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CrossFit at Monroe Mill

601 South Madison Avenue, Suite A Monroe, Georgia 30655 www.crossfitatmonroemill.com 678-635-7410

MEMBERSHIP AGREEMENT & LIABILITY WAIVER & RELEASE


MEMBER INFO
Welcome to CrossFit at Monroe Mill! We are excited to have you join us. This is a little boilerplate, we know, but we need your basic info. Help us out and fill in the information below. This form is your membership agreement. It basically talks about how you are going to pay us to workout at our facility and goes over all the fine print details. We wish it wasnt boring, but it pretty much is. The good news is that as soon as you are signed up, the boring part ends and the intense WOD fun begins! We are glad to have you as part of our community! Name Spouse Address DOB Cell Phone _______________________________ _______________________________ _______________________________ __________ Sex ___________ Work/Home Phone ____________________________ Email _______________________________

Emergency Contact ____________________________ Emergency Contact Phone Number ________________ How did you hear about us? ___________________

_______________________________

MEMBERSHIP TYPE
At CrossFit at Monroe Mill (CFAMM) we are about helping you and our community, not locking you into some big contract. Our memberships are real simple--month-to-month, quit anytime. NEVER A LONG TERM CONTRACT WITH US! Basically, sign up today and the rest of this month is ALWAYS FREE. The money you pay today, pays for the NEXT FULL CALENDAR MONTH. Any time you want to quit us (which you wont, because CrossFit and our Box are awesome) you can. All we need you to do is write us, email us or send a carrier pigeon 5 days before the 1st of the month, and we wont charge you anymore. What kind of membership are you signing up for? Please check the appropriate box below: Introductory Special-100 for 100 o Individual Membership Couples Membership Military/LEO/FF/EMS Kids & Family Memberships Corporate Membership PREPAY DISCOUNT $100.00/month $135.00/month $225.00/month $95.00/month COMING SOON! PLEASE INQUIRE! Prepay 1 year on any membership and get one month free! Buy 11, get 1 FREE! 1

First 100 members pay only $100/month for first 12 months. Regular rates after thatso hurry!

PAYMENT INFORMATION
We would do this for free if we couldit is really that much fun. But, we have to eat, pay the rent and keep the lights on. So to make all that happen, we need you to pay us a little bit every month. You can pay us 3 easy ways at CrossFit at Monroe Mill: 1) Auto-draft from your checking or savings account, 2) Auto-charge to your credit/debit card or 3) Cash or Check. How do you want to pay us? Please check the appropriate box below and fill in the needed information: MONTHLY AUTO DRAFT FROM MY CHECKING/SAVINGS ACCOUNT o By checking this option I hereby authorize CFMM, LLC, d/b/a CrossFit at Monroe Mill, to initiate a MONTHLY debit from my CHECKING/SAVINGS account (Circle One). I understand that this MONTHLY debit will be via an ACH debit initiated through my bank. This debit will occur AUTOMATICALLY on the 5th day of EVERY MONTH for the amount of my monthly membership fee then in place. I further authorize the financial institution named below to debit my account for the appropriate amount. I duly certify that I am an authorized signer of said account and have the right to authorize this MONTHLY debit. o ACCOUNT INFORMATION NAME OF MY BANK: ________________________________________ o o o CITY/STATE: BANK ROUTING #: ACCOUNT #: ACCOUNT NAME: ________________________________________ ________________________________________ ________________________________________ ________________________________________

I understand that this MONTHLY auto draft authority will remain in full force and effect until cancelled in writing by me. PLEASE ATTACH A VOIDED CHECK OF THE ACCOUNT TO BE DEBITED! Initials: ________ By initialing here I agree to be bound by the terms outlined above.

MONTHLY AUTO-CHARGE TO MY CREDIT OR DEBIT CARD o As a convenience to me, I authorize CFMM, LLC d/b/a CrossFit at Monroe Mill to place a charge to my Credit or Debit Card listed below EVERY MONTH on the 5th day of each month for my monthly membership fee then in place. I agree that I will pay for such purchase and will indemnify and hold harmless CFMM, LLC against any liability pursuant to this authorization. o CARD TYPE: AMEX VISA MASTER CARD DISCOVER (Circle One) o Card # Exp. Date CVV ________________________________________ _______________ _______________

Billing Zip Code _______________

Initials: ________ By initialing here I agree to be bound by the terms outlined above.

CASH OR CHECK o Payments by CASH or CHECK may be made in person any time at the Box. Additionally, they may be mailed to: CrossFit at Monroe Mill 601 South Madison Avenue, Suite A Monroe, Georgia 30655 o Please note that any monthly membership payments not made by the 5th of each month will automatically incur a $25.00 LATE FEE.

WAIVER AND RELEASE OF LIABILITY


CrossFit exercise is hardcore. In fancy words, it is strenuous. Before you start exercising with us, you need to know that. Also, you have to waive claims against us and release us from any liability. We want you to be safe. We will do our part to keep you safe, but you have to be careful and never push yourself too far. The lawyers require us to get you to initial each of the following paragraphs. These paragraphs affect your legal rights. READ THEM CAREFULLY AND FULLY BEFORE INITIALING. Photography/Video Release Participants involved in any activities offered by CFAMM may be photographed or videotaped during training. I hereby consent to the use of these photographs and/or videos without compensation, on the CFAMM website or in any editorial, promotional or advertising material produced and/or published by CFAMM. Initials: ________ Express Assumption of Risk I am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls which can result in serious injury or death; injury or death due to negligence on the part of myself, my training partner, or other people around me; injury or death due to improper use or failure of equipment; heart attack, stroke, orthopedic injury, cardiovascular conditions, fainting, strains and sprains, rhabdomyolysis and others. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s). I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at, or under direction of CFAMM. I acknowledge that I have no physical impairments, injuries, or illnesses that will endanger me or others. Initials: ________ Release In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities offered by CFAMM, I, the undersigned, hereby release CFAMM, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, 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 CFAMM 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. Initials: ________ Indemnification I recognize there is risk involved in the types of activities offered by CFAMM. Therefore I accept financial responsibility for any injury that I may cause either to myself or to any other participant due to a negligent act. Should the abovementioned parties, or anyone acting on their behalf, be required to incur attorneys 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 CFAMM, 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 CFAMM, at the main facility at 601 South Madison Avenue, Suite A, Monroe, Georgia 30655 or abroad. This includes but is not limited to the parking lot, pathways, parks, recreational areas, playgrounds, and all other common pedestrian areas adjacent to the main facility, and/or any area selected for training by CFAMM. Initials: ________ 3

OTHER LEGAL STUFF


This is the boring stuff. But the lawyers make us do it. Cancellation of Membership You may cancel your membership at any time. To avoid the regular monthly charge you must notify us in writing at least 5 days before the 1st day of the month. All membership fees paid are NONREFUNDABLE regardless of when you cancel. Late Fees Any membership fees not paid on or before the 5th of each month, due to late submission or returned check or declined credit/debit card charges will result in a $25.00 late fee. Lost Articles CFAMM assumes no responsibility for lost or stolen articles. Lost and found articles not claimed within 10 days will be donated to local charities. Smoking Children No smoking is allowed anywhere in our facility. ALL Members, Guest and Visitors must be 14 years of age or older. NO EXCEPTIONS! members

Conduct CFAMM is committed to the health, safety, and welfare of each of its and staff and will not tolerate unreasonable, threatening, obscene, harassing, indecent, or illegal behavior.

Damages Members shall pay for any damages to CFAMM equipment or property that is the result of willful or negligent conduct of the Member or their Guests. Rules and/or Regulations Members who do not observe CFAMM rules and regulations or follow the instructions of the trainers and staff or who abuse equipment in any fashion will be asked to leave. CFAMM management reserves the right to terminate membership to anyone who refuses to observe any of CFAMM rules and regulations. Not all rules and regulations are listed in this Agreement. No Open Gym CFAMM does not provide an Open Gym facility. Members may use the facilities only during scheduled classes, scheduled events or by appointment. Operating hours and current class schedules are listed on our website, our Facebook page and on bulletin boards at the facility. CFAMM reserves the right to change operating hours and/or class schedules at its sole discretion without any effect to this Agreement. Limited Availability CFAMM may close its Facility for seminars, certifications, maintenance, selected holidays and other hours based on local code requirements. CFAMM may delete, change, discontinue, repair, or replace any part or all of the Facility without any effect to this Agreement. Miscellaneous This Agreement contains the entire agreement between the parties and supersedes any prior written or oral agreement between them concerning the subject matter of this Agreement. This Agreement may not be waived, altered, amended or repealed, in whole or in part, except in writing signed by both parties. This agreement shall be governed by the laws of the State of Georgia, without respect to conflict of law provisions. Any dispute concerning this Agreement or any damages claimed by Member shall be addressed only in the Superior Court of Walton County. The parties agree and consent that jurisdiction and venue of said court is proper for any claims that may be brought in connection with this Agreement or the Members use of the CFAMM facilities. You as Member have read and fully agree to the terms of this Agreement and understand that by signing this Agreement, which contains a waiver, release and assumption of risk, you are giving up considerable future legal rights. You are signing this Agreement freely, voluntarily and under no duress. You further certify that you are 18 years of age or older and competent in all respects to enter into this Agreement. Member Name: Signature: ___________________________________ ___________________________________ Date: Witness: ________________________ ________________________ 4

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