JOIN NOW 40% OFF All Memberships and $99 Enrollment NOW IS THE TIME TO GET FIT! WE ARE THE BEST!! Please fill out this form and get started today. Name* FIRST LAST Email* Primary Phone*Emergency Contact Phone Address* Street Address City STATEAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Birthdate* Birthdate Month Day Year Choose Your Membership Plan* Membership Plans I hereby authorize TRINITY HEALTH & FITNESS LLC of 1650 Skylyn Drive Suite 100, Spartanburg, SC 29304, to initiate debit entries in the amount selected per month, for the term of the contract. $26 Full Time Student $36 Full Time Student + 24hr $35 Individual $45 Individual + 24hr $45 Individual + Child Watch $55 Individual + Child Watch + 24hr $53 Married Couples $63 Married Couples + 24hr $58 Family $68 Family + 24hr Enrollment FeeEnrollment Fee Price: TotalTotal Amount Today This is what you are paying today and includes the setup fee. You will only be charged monthly for your chosen plan. $0.00 Options 1 & 2 require a 30-day cancellation notice.*Choose one of the following options: Options 1 & 2 require a 30-day cancellation notice. I choose an automatic 12-month extension of the current 12-month draft agreement for a total of two years. By agreeing to this option, monthly rates will not go up after the first 12 months and no re-enrollment fee or yearly maintenance fees will be required. I choose to opt in on an automatic month-to-month extension once my 12 monthly draft requirements have been met. By choosing this option, there will be no re-enrollment fee, and my yearly maintenance of $50 will be cut in half to $25 I choose to automatically cancel my membership once my 12 monthly draft requirements have been met. By choosing this option, I will have to pay an enrollment fee to rejoin, and I will have to pay the full yearly maintenance fee of $50. Account Information Our website is secure, and for no reason will your information ever be sold or shared.Credit Card Card Details Cardholder Name Policies* Policies I have read the foregoing information and understand it. Any questions which may have occurred to me have been answered to my satisfaction. Show me the policies.. Yes, I have read the policies.. My account will be debited today and on the same day of every month by Trinity Health and Fitness and will be debited each following month during the term of the contract. I understand that this authorization will remain in full force for at least one year, and then is extended for another year unless cancelled. Also, the term will continue to renew each year until written cancellation is given in the form of a certified letter; at that time, a 60% fee on the remaining balance will be due in order to cancel. If the remaining 60% of the balance is not paid and has to be sent to a third party collections company, then 100% of the balance will be due. I also realize that cancelling or stopping payment on a draft is a criminal offense, and will be sent to the local solicitor’s office. I understand that in the event of a returned payment there will be a $20 charge. Customer's Right To Cancel: If you wish to cancel your membership at the end of any one-year term, you may send a certified letter to the address above to arrive by the 15th day of the eleventh month of the one-year contract without any penalty. (b) In addition, you or your estate may cancel the contract at any time by written notice to the address above if one of the following circumstances occurs: (1) Your death (2) Substantial physical disability, certified by a physician, which makes it permanently impossible for you to use the facility’s services. (3) Your permanent relocation to a residence more than 50 miles distant from Trinity Health and Fitness. GENERAL STATEMENT OF PROGRAM OBJECTIVES AND PROCEDURES: I understand that this physical fitness program includes exercise to build the cardio respiratory system (heart & lungs), the musculoskeletal system (muscle endurance, strength, and flexibility), and to improve body composition (decrease of body fat in individuals needing to lose fat, with an increase of weight of muscle of bone). Exercise may include aerobic activities (treadmill, walking, running, bicycle riding, rowing machine exercise, group aerobic activity, swimming, and other aerobic activities), calisthenics exercises, and weight lifting to improve muscular endurance, and flexibility exercises to improve joint range of motion. DESCRIPTION OF POTENTIAL RISKS: I understand that the reaction of the heart, lung and blood vessel system to exercise cannot always be predicted with accuracy. I know there is a risk of certain abnormal changes occurring during or following exercises which may include abnormalities of blood pressure or heart attacks. Use of the weight-lifting equipment and engaging in heavy body calisthenics may lead to musculoskeletal strains, pain and injury if adequate warm-up, gradual progression, and safety procedures are not followed. I understand that seller shall not be liable for any damages arising from personal injuries sustained by buyer while and during the PERSONAL TRAINING PROGRAM. Buyer using the exercise equipment during the PERSONAL TRAINING PROGRAM does so at his/her own risk. Buyer assumes full responsibility for any injuries or damages which may occur during the training. I hereby fully and forever release and discharge seller, its assigns and agents from all claims, demands, damages, right of action, present and future therein. I understand and warrant, release and agree that I am in good physical condition and that I have no disability, impairment or ailment preventing me from engaging in active or passive exercise that will be detrimental to heart, safety, comfort, or physical condition if I engage or participate in other than those items fully discussed on health history form. I state that I have had a recent physical checkup and have my personal physician’s permission to engage in aerobic and/or anaerobic conditioning. DESCRIPTION OF POTENTIAL BENEFITS: I understand that a program of regular exercise for the heart, lungs, muscles and joints has many benefits associated with it. These may include a decrease in body fat, improvement in blood fats and blood pressure, improvement in physiological function, and decrease in risk of heart disease. Do you agree to the policies stated above?*Do you agree to the policies stated above? I Agree I Disagree NameThis field is for validation purposes and should be left unchanged.
