Contact Details: Tel: 011 245 6013 Fax: 086 585 2758 E-mail: [email protected] GYM MEMBERSHIP AGREEMENT DETAILS OF MEMBER First Names: …………………....……………… Surname: ………………………….......…………… Identity / Passport Number: ….…..................................................…………………… Contact Details: E-mail: ………………………………………………………......…………………………..................... Tel Home: ………………………………..………… Work: ………………………………………… Mobile: ……………………………………………. Residential Address: ………………………………………………………………………………………………………………………… …………………..................................................................................................……. Postal Address: ………………………………………………………………………………………………………………………… …………………………........................................................................................……… MEMBERSHIP START DATE - ……………. DAY OF .………………………. 20…. MEMBERSHIP FEE: I agree to pay to Legacy Balance (Proprietary) Limited (“Legacy”) – a joining fee of R350-00 incl. VAT; and R ……………………. per annum incl. VAT (“membership fee”) for the access and use of the health and leisure facilities of Legacy. I hereby agree to pay to Legacy the membership fee – in a once-off payment of R ………………… ; Cash [ ] Cheque [ ] Credit card [ ] Internet Transfer [ ] (Legacy Fitness, Nedbank, North Rand, Branch Code: 146-905, Account number 1469 154 358) Or a monthly debit order of R……………………………, details supplied on separate form, hereby attached. I confirm that I have read and understood the terms and conditions of this membership agreement and the use of the gym facilities. Type of membership (please tick appropriate option):  Normal Membership  Personal Training Membership  Special Membership Gym client would like to train at (please tick appropriate option):  Michelangelo Hotel  Michelangelo Towers level 8  Raphael Penthouse Suites  DaVinci Hotel & Suites Signature Date CONDITIONS OF USE OF GYM FACILITIES 1. Cardiovascular equipment may not be used for more than 20 minutes continuously during peak times. 2. Members must put their own weights away after using a particular piece of equipment. 3. Members must make use of a sweat towel at all times when training. If hotel sweat towels are used thy must be returned after the exercise session. 4. Appropriate training clothes and shoes must be worn at all times. 5. Members must act in a reasonable and considerate manner to others in the facility. Excessive noise and talking which may be distracting should be avoided. 6. The use of cell phones within the exercise area is prohibited and should be switched off or placed on silent. 7. Members must treat the facility and equipment with care. 8. Legacy Balance reserves the right of admission to the facility. 9. Members are encouraged to leave all clothing and valuables locked in lockers provided, as safe keeping cannot be guaranteed by management. 10. No possessions should be left in lockers after members have finished training. 11. No guns or any objects that can be used as weapons will be allowed in the facility. 12. No smoking, food or alcohol will be allowed in the facility. 13. Members must abide by the above rules at all times, and any other rules that may be deemed fair and appropriate at a later stage. MEDICAL Physicians Name: …………………………………………… HISTORY Contact number: ……………………………………………………. Do you have, or have you ever in the past had Please state whether you Do you have, or have you ever in the Yes No Please state whether you Yes No past had: 1. 2. 3. 4. 5. 6. Heart problems, chest pain or stroke? Increased blood pressure? Breathing and lung problems? Increased cholesterol? Any chronic illness conditions? Debilitating illness, e.g. rheumatic fever? 7. Difficulty with physical exercise? 8. Advised by doctor not to exercise? 9. Muscle, joint or back disorder? 10. Diabetes or thyroid condition? 12. Have a cigarette smoking habit? 13. Have had recent surgery? 14. Have had a previous injury which still affects you? 15. Have a history of heart disease in your family? 16. Have had a hernia or similar condition which may be aggravated by training? 11. Comments: Weight problems, anorexia, etc? e.g. obesity, ……………………………………………… ………….…………………………………… …………………………………….……….. TERMS AND CONDITIONS 1. DURATION OF MEMBERSHIP AND AUTOMATIC RENEWAL 1.1 The membership period will commence on the 1.1.1 signature of this agreement by member if the payment of the membership fee is by means of a once-off payment in full or 1.1.2 the third working day after the signature of this agreement by the member if payment of the membership fee is by means of a monthly debit order (“Commencement Date”) and will continue for a minimum 12 (twelve) months period calculated from the commencement date (Initial Period) and will thereafter automatically continue to be renewed for further fixed period(s) of 12 (twelve) months each (Renewal Period(s), unless terminated by the member on at least 1 (one) calendar month’s written notice to Legacy prior to the last day of the Initial Period or any Renewal Periods, as the case may be (Termination Notice). In Renewal Periods cancellation will only be accepted with 3 months notification. Any Termination Notice must be received by Legacy Balance at the following address: Legacy Balance, Acacia House, 5 Autumn Road, Rivonia, 2128, to be of force and effect. 1.2. Membership is not transferable. 1.3 Membership will not be suspended if unused during the Initial Period and any Renewal Period(s). 2. 2.1 2.2 3. 3.1 NO LIABILITY AND INDEMNITY I agree and acknowledge that Legacy Balance will not be liable for my death, any injury, loss or damage suffered by me arising from any act and/or omission on the part of Legacy Balance, its directors, employees, contractors, independent consultants or other member(s). I agree and acknowledge that I enter and exit the gym’s premises (inclusive of parking areas) and use the equipment and facilities entirely at my own risk. In addition, I agree that Legacy Balance shall not be vicariously liable for any loss or damage suffered by me as a result of theft on the part of its employees, independent contractors, consultants or other member(s). I and/or my estate hereby indemnify Legacy Balance against any claim by any person arising directly or indirectly from my death, injury, loss or damage suffered by me, allegedly caused or contributed to by an act or omission by Legacy Balance, its directors, employees, contractors, consultants and agents. MEMBERSHIP FEES Legacy Balance may, after the Initial Period, increase the membership fees for any Renewal Period with such amounts as Legacy in its sole and absolute discretion deems appropriate. Legacy Balance may also, 3.2 3.3 3.4 3.5 3.6 3.7 4. 4.1 in its sole and absolute discretion, increase the membership fees during the currency of the Initial Period and/or any Renewal Period, from time to time, in line with any cost increases to Legacy in regard to providing the gym facilities to members. Monthly debit orders will be submitted on or about the first working day of each month. The full outstanding balance, if any, will become due and payable if I fail to pay any instalment on due date thereof, in which event I will become liable and pay all costs in connection with the collection of any amounts due by me in terms of these terms and conditions including legal costs on the scale as between attorney and own client, inclusive of collection commission. I shall be liable to pay interest at the prime rate, being the publicly quoted rate of interest, compounded monthly, at which FirstRand Bank Limited lends on unsecured overdraft to its most favoured corporate customers in the private sector from time to time, on any amounts due and payable in terms hereof and which is not paid on due date. Interest shall be calculated from due date until the date of receipt of payment by Legacy Balance. A certificate by a branch manager of FirstRand Bank Limited, whose appointment does not need o be proved, shall be final and binding on the parties. Access to Legacy Balance gyms and facilities may be denied until such time as Legacy Balance has received payment in full of the arrear instalment(s), plus interest accrued thereon and legal costs on the scale as between attorney and own client, inclusive of collection commission, if any. In the event that my bank details and/or contract details change, I will promptly inform Legacy Balance in writing with the updated information. Should the member wish to cancel the agreement within the first year the member shall be liable for the full first year’s membership fees. Should the member wish to cancel the membership within the second or subsequent renewal periods the member will have to give Legacy Balance three (3) months’ written notification of the cancellation. Payments are not refundable. GENERAL This agreement constitutes the sole record of the agreement between the parties in relation to its subject matter. 4.2 Neither party shall be bound by any representation, warranty, promise or the like, not recorded in this document. 4.3 No addition to, variation, novation or agreed cancellation of this agreement shall be of any force or effect unless in writing and signed by or on behalf of the parties. 4.4 No suspension of a right to enforce any term of this agreement and no pactum de non petendo shall be of any force or effect unless in writing and duly signed by or on behalf of the parties. 4.5 No indulgence which a party may grant to the other party shall constitute a waiver of any of the rights of the grantor unless in writing signed by both parties. 4.6 The provisions of this agreement shall be binding upon the successors-in-title- and the permitted assigns of the parties 4.7 No remedy conferred by this agreement is intended, unless specifically stated, to be exclusive of any other remedy which is otherwise available at law, by statute or otherwise. Each remedy shall be cumulative and in addition to every other remedy given hereunder or now or hereafter existing at law, by statute or otherwise. The election of any one or more remedy by a party shall not constitute a waiver by such party of the right to pursue any other remedy available at law. 4.8 All notices and processes, may be validly delivered or served upon me at my postal address as aforementioned, which address I hereby choose as my domicillium citandi executandi for purposes thereof. 4.9 Legacy Balance reserves the right to cancel this agreement on notice if I breach any of the terms and conditions of this agreement inclusive of the rules of the gyms in force from time to time and/or if the information supplied by me is found to be incorrect and/or false and/or if Legacy, in its absolute discretion, considers that I am not physically and medically fit to proceed with the normal routine of exercise. I confirm that I have familiarised myself with the code of conduct in force from time to time. 4.10 Services the client is entitled to for membership that are not claimed are not transferable and may not be claimed after the date on which the service is offered. If membership includes 12 personal training sessions per month and client misses a month, he/she may not claim 24 sessions the following month.