Van Buren Athletic Club, 24/7 Access
CONSENT FORM/PRIMARY MEMBER AGREEMENT
Full Name N/A
Home Address: N/A
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Birthday (Month/Day/Year): N/A
I hereby acknowledge that (a) I understand that use of the Van Buren Athletic Club’s facilities, services, programs and premises includes an inherent risk of injury to persons and property; (b) that I am in good physical condition and have no disability, illness or other condition that could prevent you from exercising without injury to yourself or impairing your health and (c) that I have consulted a physician concerning an exercise program that will not risk injury to myself or impairment of my health. Such risk of injury includes, but is not limited to, injuries arising from use by myself or others of exercise equipment and machines, injuries arising from participation by myself or others in supervised or unsupervised activities or programs throughout Van Buren Athletic Club, injuries and medical disorders arising from exercising at Van Buren Athletic Club such as heart attacks, strokes, heat stress, sprains, broken bones, torn muscles and ligaments, or death, among others and accidental injuries occurring anywhere in Van Buren Athletic Club including, without limitation, locker rooms, showers, dressing rooms, exercise room, daycare area, tanning area, or outside exercise area. If I have any special exercising requirements limitations, I agree to disclose them to Van Buren Athletic Club and/or its personnel when seeking help in establishing an exercise program. I hereby agree that all the exercises and use of Van Buren Athletic Club's facilities, services, programs, and premises and undertaken by myself at my sole risk. I hereby release and hold J&L Fitness LLC, Van Buren Athletic Club and/or its owners, employees and agents harmless from and hereby assume all responsibility for all claims, demands, injuries, damages, actions or causes of action whatsoever, to person or property, arising out of or connected with my use of Van Buren Athletic Club’s facilities, premises, services or programs. I acknowledge and understand that J&L Fitness LLC, Van Buren Athletic Club and/or its personnel, in the event of an emergency has the right to send me to the emergency room for an evaluation and I hereby agree not to hold J&L Fitness LLC, Van Buren Athletic Club and/or its personnel liable for its decision or for any charges related to the services I may receive. I understand that those members who bring children to the Van Buren Athletic Club accept full responsibility for the safety and well being of their children to the Van Buren Athletic Club. I also understand that J&L Fitness, Van Buren Athletic Club, and/or its personnel are not responsible for lost or stolen property.
I hereby acknowledge that Van Buren Athletic Club is a 24/7 fitness center and accept full responsibility to use the facility unsupervised and unattended. I understand that J&L Fitness LLC/Van Buren Athletic Club provides an emergency necklace to wear when unattended in the facility and in case of an emergency, will hold it for 15 seconds and emergency personnel will be notified. I understand that in order to access Van Buren Athletic Club, I will enter a unique pin number and will not share that number with anyone who is not a member; that if someone other than myself enters with myself, or with my pin number, my membership may be revoked or I may be prosecuted. I hereby agree to have all guests sign a waiver upon entering and pay a $5.00 daily use fee. J&L Fitness LLC/Van Buren Athletic Club reserves the right to immediately terminate your use of, or access to, this facility at any time if decided at its sole discretion that you have breached this agreement or any relevant law, rule or regulation, or you have engaged in conduct that J&L Fitness LLC, Van Buren Athletic Club and/or its personnel considers to be inappropriate or unacceptable. With such understanding, I wish to participate in programs offered through my membership and agree to follow the rules of conduct for Van Buren Athletic Club.
DATE: 4/1/2026
- I hereby agree to accept & abide by the terms of this membership agreement. I understand that this membership agreement is for a term of TWELVE (12) MONTHS & will continue thereafter on a month-to-month basis unless cancelled.
- I hereby authorize VBAC to effect payment for monthly membership fees for the duration of my membership through electronic funds transfer. This authorization is to remain in full effect until VBAC receives a 30 DAY WRITTEN NOTIFICATION from me.