Application Form Single. Club Location The George Hotel, Chollerford. Members Details. Next of Kin Details. M/ship Type: Peak Off Peak 6 Week

Transcription

1 Application Form Single Club Location The George Hotel, Chollerford. Members Details. M/ship Type: Peak Off Peak 6 Week Title: Surname: Fore Name(s): Date of Birth: Address: Postcode: Telephone Daytime: Evening: Mobile: Next of Kin Details Name: Address: Postcode: Telephone Relationship:

2 Payment Options (office use) Option Tick 12 Month annual cash 12 Month annual cheque 12 month annual credit card Monthly Direct Debit Direct Debit Start Date Membership Number: Membership usually runs for a period of 12 months from the date of joining, however some clubs operate a prescribed membership yeardetails will be provided at each club. Any renewal of membership made at the end of the first year and each subsequent membership period will be in accordance with the membership terms and conditions of usage. By signing you have read the membership terms and conditions and have agreed to be bound by them. Sign: Date: Staff Member Sign: Date:

3 Page 2 Physical Activity Readiness Questionnaire The Questions below will indicate if you need to check with your Doctor before you start exercising. If you are over 69 years of age and not currently active you should consult with your doctor prior to commencing an exercise regime. Please read the questions below and answer honestly (Circle the most applicable answer) Has your Doctor ever said that you have a heart condition and you should only do physical activity recommended by a doctor? Do you have high blood pressure? Do you have any pain in your chest when you do physical activity? In the past have you ever had chest pain during physical activity? Do you lose you your balance because of dizziness or do you ever lose consciousness? Do you have a bone or joint problem that could be made worse by a change in your physical activity? Are you currently taking any prescribed medication excluding the contraceptive pill? Do you know of any reason why you should not be undertaking physical activity? If you have answered any of the above questions with a yes you will need to consult with your GP BEFORE you start becoming more physically active or BEFORE you have a fitness appraisal. We will need written confirmation from your GP before you begin using the gym. Declaration I have read, understood and completed the above questionnaire and understand: That there are risks and dangers inherent in physical exercise and duly undertake the activity at my own risk. Any liability on the part of the operators is excluded unless negligence can be proven. I agree to observe the rules and conditions of membership. I also acknowledge that I must not use any piece of equipment for which I have not been shown how to use by an instructor. That should I become aware of any relevant changes to my health or condition, I must inform an instructor. Signed Staff Initials

4 Edition 3- August 2008 Terms of membership: The George Leisure Club shall be operated as a propriety club owned by Shearings & located at: The George Hotel Chollerford Hexham Northumberland NE46 4EW The club will be administered by Shearings, or by another nominated person. The owner shall solely determine the facilities of the club; any amendment or replacement shall be at the owner s discretion. It is the aim of The George Leisure Club to provide a pleasurable part of your leisure time. To that end we have put together some simple terms of membership whish we hope will ensure all members are able to enjoy the club safely & without being inconvenienced. We welcome all members comments & suggestions. Access: 1. Members must present their membership card each time they visit the club. Hotel guests must present their room card, not their key. The club reserves the right to refuse entry without presentation of these items. 2. Entry will be refused to anybody under the influence of alcohol or drugs. 3. Appropriate clothing & footwear must be worn in the club. In the gymnasium, studio & swimming pool areas outdoor shoes must not be worn. Swimming costumes must be worn in the pool, spa bath, sauna & steam room. Swimsuits & exercise clothing, with the exception of tracksuits, my not be worn in the public area s of the hotel. 4. No animals are permitted in the club, other than guide dogs. 5. The club will open Monday to Sunday. Last entry 30 minutes before closing. These hours may vary on bank holidays & over Christmas, New Year & Easter. 6. The club reserves the right to close facilities without prior notice should the need arise. Whenever possible advanced notice will be given. 7. Members may be accompanied by a maximum of 2 guests at any one visit, unless prior arrangements have been made with the club manager. 8. Only adult members are permitted to sign in guests. 9. The club reserves the right to refuse admission to any guest. 10. The club reserves the right to terminate membership without giving reason. (Refunds may be available subject to circumstances of membership termination) Health & Safety:

5 1. Please shower before using the swimming pool, spa, sauna & steam room. 2. Prior to using the gymnasium, a physical activity readiness questionnaire must be completed & signed. If you have answered yes to any of the questions asked, you will be referred to your general practitioner for clearance before use of gym is permitted. 3. In the sauna or steam room, reading, shaving or the drying of clothes & towels are not permitted. 4. Running, jumping, diving or any other activity that may cause harm to other pool users is not permitted in or around pool area. 5. Members must accept responsibility for their guests & ensure that they abide by the terms of membership. Members must be with their guests at all times. 6. Food & drink are not permitted on pool side or in the changing rooms. 7. Glass (including face masks made from glass) & crockery is not permitted anywhere in the club other than reception/lounge area. 8. Smoking is not permitted anywhere in the club. 9. Please ensure that you have read the pool rules signage before using the pool facilities. Children: 1. Children under the age of 16 may use the club from 0730 until 2130 Monday to Sunday & bank holidays. 2. An adult must accompany children under the age of 15 at all times. 3. Children under the age of 16 are not permitted to use the gymnasium. 4. Children under the age of 6 are not permitted to use the spa bath. Under 15 s must be supervised. 5. Children under the age of 12 are not permitted to use the sauna or steam room. Under 15 s must be supervised. 6. There must be at least one adult 18 or over to every two children under the age of 15 entering the pool area. All children must be supervised at all times whilst on the premises. 7. There is no entry fee for children under the age of 4 years old. Administration: 1. The club management reserves the right to reject any application for membership without reason. 2. The clubs fees & tariffs shall be determined by the club & may be altered at any times. Members will be notified in advance of any changes. 3. The club reserves the right to terminate the membership of any member without notice in the event of a member committing a serious breach of the clubs terms of membership. 4. On cancellation or termination of membership, no refund will be made. 5. All members who cancel their membership must do so in writing giving 28 days notice.

6 6. Membership cards are only for use by the member & are not transferable under any circumstances. Other Terms: 1. Radios, mp 3 players, mobile phones or any other items likely to cause annoyance may not be used in the club. 2. Ball games & inflatable toys & rafts are not permitted in the pool unless incorporated into a planned children activity. 3. Lockers should only be used for storage of personal belongings. 4. Property is stored at the owners risk & the club will accept no liability for loss or damage. 5. Lockers will be cleared every 24 hours & all items removed. 6. The club reserved the right to dispose of any items not claimed within 4 weeks. 7. The club reserves the right to amend these terms at its absolute discretion. Notification of changes will be displayed on the notice board Data Protection Act: 1. We take the privacy of our members seriously. This statement explains the ways in which we use your personal information. If you have any queries with regard to our processing please contact us on We collect personal information from you through the membership form & your use of our facilities. The information we collect may relate to your physical health or condition. 3. We use your personal information for the purpose of providing & personalizing our membership services & providing you with information about products & services offered by us or our business partners & third parties. I confirm that I have read the above terms & conditions & agree to abide by them. Print name Signature