MEMBER REGISTRATION
Membership Type:
Single Month to Month Membership
Enrollment Fee:
$ 75.00
First Month Dues*:
$ 31.79
Total Due:
$ 106.79
Billing Begins:
11/01/2024
Dues:
$ 49.99
*Prorated
PERSONAL INFORMATION
First Name / MI
Last Name
Address 1
Address 2
City / State
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NY
NV
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
WA
WI
WV
WY
Zip
Drivers License
Birthday
Home Phone
Cell Phone
E-Mail
Confirm E-Mail
Emergency Contact
Emergency Phone
Hear About us?
CORPORATE
COURTESY LIST DAY
DIRECT MAIL
DO A FRIEND FAVOR
DOOR HANGER
DRIVE BY
EMAIL MARKETING
FAX MARKETING
FAMILY
FLYER
FRIEND
FUND RAISER
GUEST
INTERNET
LEAD BOXES
MAGAZINE
MEMBER
MOVIE THEATRE
NEW MEM SURVEY
NEWSPAPER
OPEN HOUSE
POINT OF SALE
RADIO
SIGN
SILVERADO THEATRE
TV
WEBSITE
BILLING INFORMATION
How would you like to pay for your monthly dues?
I want to use my bank account.
Credit Card Number
Expiration Month
01
02
03
04
05
06
07
08
09
10
11
12
Expiration Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
Bank Name
Routing/Transit Number
Account Number
TERMS AND CONDITIONS
I have read and agree to the cancellation policy.
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I have read and agree to the membership terms and club rules.
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I have read and agree to the waiver of liability.
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Member
Parent/Guardian
WAIVER OF LIABILITY
Member acknowledges and accepts the risks inherent in the use of Impact Athletic services and facilities. By use of the Club facilities and services, the Member hereby voluntarily assumes the risks of injury, accident, death, loss, cost, or damage to his or her personal property which might arise from the use of Impact Athletic services or facilities. The Member, his or her heirs, executors, representatives or assigns, hereby releases Impact Athletic for all claims and liabilities for personal injury or property damage of any kind sustained by the Member while on the premises of Impact Athletic. Member further certifies that he or she is in good physical health and able to undertake and engage in the physical exercise or sports activities in which he or she chooses to participate.
CANCELLATION POLICY
The term of this agreement is 1 months. Monthly dues or the terms of this agreement shall be 49.99 plus tax per month. If monthly dues are not kept current the full amount of your contract will be due. The member may terminate his or her membership after the expiration of the terms set forth above by certified letter or signing a cancellation form at Impact Athletic 30 days prior to the termination date and receiving a copy of the cancellation. Accounts must be paid in full at time of cancellation. Absolutely no phone cancellations. If membership is not cancelled as stated above the membership will automatically be renewed on a month to month basis. A $200.00 cancellation fee will be added to any membership canceling before the terms of the agreement. In the event that an account become delinquent and balanced owed is placed with a licensed collection agency, a Collection Processing Fee will be added to the amount owing.
TERMS AND CONDITIONS OF MEMBERSHIP
This agreement represents the complete understanding between the Member and Impact Athletic. No representations, written or oral, other than those contained within this agreement are authorized by or binding Impact Athletic.
Monthly Dues: Member is entitled to use Impact Athletic facilities within the scope of the type of membership selected. The member is obligated to pay monthly dues regardless of whether or not the Member actually uses Impact Athletic facilities. Upon expiration of the terms of this agreement, Impact Athletic may adjust monthly dues. Enrollment fees, prepaid dues and memberships are non-refundable and non-transferable. Dues quoted are based on EFT pricing. An additional $10.00 charge will be added if EFT information is not received before billing runs.
Rights of Members: Members shall have the right to use the facilities and equipment located on the Center premises as set forth and subject to the rules and regulations of membership established by Impact Athletic. Member agrees to obey the rules and regulations of membership now or in the future prescribed by the Center for the use of equipment or other facilities of Impact Athletic.
Rules and Regulations: The Rules and Regulations of the Center are a part of this contract as though fully set therein. Member acknowledges receipt of a copy of the Rules and Regulations. Management may, from time to time change the rules and regulations governing the operations of Impact Athletic. Management may suspend or cancel the rights, privileges or membership of any member whose actions are detrimental to the enjoyment of Impact Athletic facilities by other members.
Attorney Fee: Should member breach any term of this agreement, Member agrees to pay Impact Athletic all attorney fees and court costs incurred. Member will be liable for payment of all costs incurred by Impact Athletic for past due obligations.
Authority to Sign: By executing this agreement, the undersigned represents to Impact Athletic that the undersigned has full authority to sign on behalf of all persons listed on this contract. Should any person listed or any guest of Member bring action against Impact Athletic for any reason, Member agrees to indemnify Impact Athletic, its officers, members and employees for all costs, attorney fees and any other damages for which Impact Athletic may be liable.
Entire Agreement: This agreement, together with the Rules and Regulations of the Impact Athletic contains the entire agreement between Member and Impact Athletic. No representations, express or implied statements, promises, or inducements made by any part not contained in this agreement or the Rules and Regulations of Impact Athletic shall be binding and valid unless attached to this agreement in writing.
Membership is non-transferrable. If member allows membership or card to be used by someone other than members on contract they will be subject to a $200.00 fine.
The purpose of this agreement is to ensure that the Member understands the duties and responsibilities of Impact Athletic membership. This is a legal binding agreement and if it is not understood by the Member, he or she should consult an attorney of his/her choice.
I (We) hereby apply for a membership at Impact Athletic
I (We) hereby certify that I (We) have read and understand the terms of this agreement as well as the membership
Bylaws and rules and regulations, and agree to abide by such rules and regulations.