Hope Place Women’s Fitness
ONLINE MEMBERSHIP AGREEMENT AND DRAFT AUTHORIZATION
I understand that participation in the Hope Collaborative activities includes the risk of injuries, illnesses or death. I expressly acknowledge on behalf of myself and my heirs that I assume the risk of any and all injuries and illnesses, which may result from my participation in these activities. I hereby release and discharge the Hope Collaborative, its agents, servants, and employees from any and all claims for injury, illness, death, loss or damage which I may suffer as a result of my participation in these activities. The Hope Collaborative conducts regular sex offender screenings on all members, participants, and guests. If a sex offender match occurs, the Hope Collaborative reserves the right to cancel membership, end program participation, and remove visitation access. I understand that the Hope Collaborative cannot be responsible for personal property lost or stolen while guests, member and/or program members are using Hope Collaborative facilities or on Hope Collaborative premises. There may also be times when the Hope Collaborative may take photographs (or other digital images) of myself or my children participating in activities. Those images may appear in the Hope Collaborative?s, promotional materials or publications, including electronic publications. By signing this form, I am giving permission to the Hope Collaborative to use my image or those of my children for the purposes listed above.
I authorize my reserves bank to honor preauthorized Electronic Funds Transfers (or credit card charges) against my account for (membership/program/contribution) payments as indicated below. When the bank honors the EFT (or credit card) by charging my account, such transfer shall constitute notice of payment due and my receipt for the payment. Should any preauthorized EFT (or credit card) not be honored by said bank when received by them, then it is understood that the payment is to be made by me in the amount of said payment plus a $10 service charge. It is further understood that if such payment is not honored by the bank (or credit card institution), then the Hope Collaborative, at its discretion, may resubmit the amount due for payment on a future date. I understand I must give a 5-day written notice prior to draft date to stop my draft.