Planet Fitness Online Application Form – Fill Out and Use This PDF

Naional access

R 355

R 323

Naional access

R 355

R 323

Staring date: Home club: Package type:

Personal details Title:

Surname: Date of birth: Tel no. (work): E-mail address: Postal address:

Iniials:

Monthly amount: R Contract no.:

First name(s):

ID.:

Passport no.: Cell no.: Physical address:

Service of interest?

Lifestyle

Smoker?

Drinker?

Drinks per week? Take-aways per week? Energy level?

Stress level?

Family support?

Bank account details for debit order

Account holder name:

Bank account no.:

Branch code:

Bank:

Branch name:

Account type:

I, the undersigned, do acknowledge and agree that:

a.I have contracted directly with Planet Fitness to access Planet Fitness and that I am legally bound to setle any amounts due for such access to Planet Fitness.

b.This agreement is also subject to the terms and condiions of the agreement entered into between Planet Fitness (“the company”) and Universal 360°.

c.I have familiarised myself with the rules of Universal 360° and shall adhere thereto.

d.I have entered into this agreement by virtue of my paricipaion in the Universal 360° programme, a division of Universal Healthcare Services (Pty) Ltd.

e.I will be enitled to use and access the health and leisure faciliies of the company subject to:

i.Conirmaion from Universal 360° of my Universal 360° membership.

f.I accept that if I join Planet Fitness and I do not acivate through Universal 360° within one month or am no longer a Universal 360° member, Planet itness will bill according to the

standard going Planet Fitness rate for the remainder of the term, ater which it will coninue on a monthly basis unil Planet Fitness receive one month’s noice to cancel.

g.I further allow Planet Fitness to deduct any monthly fees from my bank account that may become due in terms of this beneit should I fail to acivate or disconinue my membership with Universal 360°.

h.The iniial period of the contract is 12 (twelve) months, where ater the contract may be terminated on one month’s noice. I further understand that I have a ixed membership rate for this 12 months.

i.Planet Fitness will implement an annual increase which will only apply once my 12 (twelve) months contract has expired whether I am uilising the gym under the Universal 360° beneit or through the standard Planet Fitness rate.

j.Payment of the prevailing access tag fee:

i.Signature of this form

ii.Payment of monthly debit order to Universal 360°.

iii.My compliance with the rules and regulaions of the Planet Fitness beneit and the terms and condiions of this agreement.

k.I acknowledge that I am not enitled to suspend my Planet Fitness access, during the iniial irst 12 (twelve) months of this contract.

l.My contract agreement will be transferred to Planet Fitness if I cancel the beneit with Universal 360° or cancel my Universal 360° membership. I am aware that I will be required to honour my contract for the full term with

Planet Fitness at the full relevant retail rate of the facility.

m.I will ensure that my visits to Planet Fitness are recorded accurately by using my access card. It is my responsibility to ensure that my visit is recorded in the register should the system used for recording points not be operaional.

n.I am physically and medically it to proceed with the normal rouine of exercise and acknowledge that the company, Universal 360° and any member of the Universal Healthcare Group of companies will not be responsible for any injury or loss sufered by me/or the junior member(s), whether through any negligence and/or omission on the part of the company or for any reason whatsoever. In the event of my signing this agreement as the guardian of a minor, I hereby consent to the minor being bound to the terms and condiions of this agreement and I indemnify Universal 360° and the company for any loss and damages arising from any claim resuling from the minor’s use of and access to the faciliies.

o.I accept that the company may require me to pay for use of addiional services and faciliies speciied from ime to ime. The company will charge the same general tarifs charged to ordinary members of the public for such addiional services and faciliies. The terms of this agreement do not pertain to such addiional services and/or faciliies.

p.I accept that access to the company’s faciliies will be denied unil such ime as the company has received payment in full of any arrear fees.

q.I accept that the company and Universal 360° reserve the right to cancel my access if I breach any of the terms and condiions of this agreement or any rules and regulaions applicable at the company faciliies.

r.In the event of one or more of these terms, condiions, rules and/or regulaions being unenforceable, the same will be deemed to be severable from the remainder of this agreement.

s.I conirm that the informaion contained herein is true and correct. I understand that I cannot

cede or assign any of the rights or obligaions in this agreement to any third party.

t.Universal 360° and the company reserve the right to cancel this agreement if the informaion supplied is incorrect.

u.I accept that Universal 360° will be enitled to amend the terms and condiions hereof at any ime on the proviso that the amendments are communicated to me in wriing and are furnished to me imeously.

v.The company may transmit details of my usage records of the faciliies to Universal 360°.

I authorize both Universal 360° and the company to disclose to one another personal informaion pertaining to my Universal 360° membership and my access to the faciliies from ime to ime on the proviso that such informaion is kept conidenial.

I have read this enire agreement inclusive of the rules and regulaions applicable at the company faciliies, a copy thereof was provided to me and agree to be bound thereby.

Signature (client)

Signature of legal guardian

(if the member is under 18 years of age)

The rules and regulaions will be displayed where applicable and are avail- able upon request. The client undertakes to abide by all the rules and regulaions as set out by management and conirms that they understand them fully.

Access cards

Access cards are for the exclusive use of the client. No client will gain access to the facility without a card. Loaning of access cards to other mem- bers and non-members is prohibited. Should a non-client present a client’s card, Planet Fitness will coniscate the card and the member’s membership shall be summarily terminated at the sole and absolute discreion of Planet Fitness. Lost or stolen cards may be replaced at a fee sipulated by manage- ment. If a membership card is let at home, access will be permited upon the member displaying an idenity document or driver’s license.

Access fees

The member will not be released from their obligaion regarding any payment of the membership fees as agreed to herein. The member is not en- itled to any deducion or allowance for any payment made, by reason of the member’s absence or withdrawal from the club, nor by the member’s failure to atend or to use the facility. Membership fees are strictly non-refundable.

Ancillary charges

Further charges may be levied for private training sessions, diet plans, assessments and similar addiional services.

Reciprocal facility

Planet Fitness does not guarantee nor take responsibility for the avail- ability or usage of any reciprocal facility not owned by Planet Fitness. The member indemniies Planet Fitness against inconvenience sufered as a re- sult of the above unavailability, whether temporary or permanent and un- dertakes not to insitute any claim and/or acion against Planet Fitness in relaion to the above. Reciprocal faciliies cannot be used on a full-ime basis and certain faciliies may charge an addiional fee at their discreion.

Closure of facility and/or alteraion of hours

Should the facility deem it necessary, in the sole and absolute discreion of the facility, to perform maintenance work on the premises, the facility can close for the period required for compleion of the necessary maintenance.

If, in the sole and absolute discreion of the facility and due to unforeseen circumstances, a facility has to be closed on a permanent basis, Planet Fitness reserves the right to provide an alternaive facility, within a 25km radius.

The business hours will be displayed at the premises and the facility reserves the right to alter the business hours from ime to ime, as it deems it. The classes may be disconinued or the ime altered at the sole discreion of the facility. Equipment and classes shall be provided subject to demand.

Children

Certain restricions apply to children under the age of 18. Please refer to a consultant at your branch for details in this regard.

Right of admission to faciliies reserved

Right of admission to Planet Fitness South Africa (PTY) Ltd. (‘the Company”) is reserved.

Limitaion of liabiliies

Planet Fitness will not be liable or responsible for any thet, death, harm, damage, injury, loss or damage sufered by the member and/or their depen- dants and/or estate through or contributed to any cause whatsoever, including but not limited to any negligent (including gross negligent) act which occurred while the member and/or their dependants used the faciliies, which faciliies the member warrants they are suiciently it to use, nor shall Planet Fitness be liable for any act or omission or breach of contract on the part of Planet Fit- ness, its directors, employees, contractors, independent consultants or other member/s. It is the member’s sole responsibility to ensure that they are suf- iciently it to take part in any exercise or acivity ofered by Planet Fitness. The member indemniies Planet Fitness for any sufered due to faulty equipment and/or injury sustained by the member either inside or outside of the facility. I agree and acknowledge that I enter upon and exit the premises including park- ing areas and use the equipment and faciliies enirely at my own risk.

Clothing and hygiene

The club reserves the right to deny use of the club to any person whose at- ire is not considered being appropriate in connecion with the public image of the club and its rules and regulaions. Athleic shoes are required in all exercise areas. No black-soled shoes are permited on the squash courts or aerobics loor. Clients must use a sweat towel at all imes and must wipe equipment before proceeding to the next staion. No member may exercise without a top. Proper swimming aire is required to be worn whilst uilising the pool area, steam rooms and saunas. Clients are required to wear swimming caps when uilising the pool. Clients are required to shower before entering the pool.

valuables and personal property

Planet Fitness will not be responsible for any loss, thet or damage to personal property of the member, dependant, guest or any third party. The member waives the right to sue the facility for any loss, thet or damage to personal property.

Non-variaion of agreement

This is the enire agreement between the paries and no representaion, promise, warranty and/or agreement not contained herein shall be any force and efect between the paries. No extension of ime or indulgence granted to the client will prejudice the rights of the facility in terms of this agreement.