G U E S T   S I G N   I N
 
Code:
 
 
 G U E S T   I N F O R M A T I O N
   
 First Name*   MI  
 Last Name*
 Address 1*
 City*   St  
 Zip*
   
   
Birthday*
Cell Phone*
E-Mail*
Source*
   
   
 W A I V E R
   
  I accept responsibility for my use of any and all apparatus, appliances, facility, privilege or service whatsoever, owned and operated at this club at my own risk, and shall hold this club, its owners, shareholders, directors, officers, employer's representatives and agents harmless from any and all loss, claim, injury, damage, or liability sustained by me resulting therefrom.
   
 
Parent/Guardian/Payor