Membership Application 1. Personal Details Title: Forename: Student/Staff ID Number: Surname: BU AUB Address: Home Tel No: Male Mobile Tel No: Female e-mail: Date of Birth: (dd/mm/year) Emergency contact name: Course: Relationship: Tel No: PLEASE NOTE: by providing these details you consent to sportBU, whether directly or through an intermediary, processing this information for the purposes of your application and on-going membership. 2. Membership Type and User BU Community Corporate £10 for 10 days (available once per term) Annual sportBU Membership sportBU Membership Termly/Quarterly** Varsity sportBU Membership Pay-As-You-Go Staff Salary Deduction – 12 month minimum term contract*** *Please note this price applies for BU students & staff, AUCB students & staff, alumni and partner college students. ** BU memberships are termly, community and corporate memberships are quarterly. *** Only available to BU employees 3. Medical Conditions Are you currently taking any medication? Have you suffered or do you suffer from chest pains? Have you suffered or do you suffer from back pain? Are you currently carrying an injury? Are you currently pregnant or have been pregnant in the last year? Do you ever feel faint or have spells of dizziness? Do you suffer from Asthma? Do you smoke? Has anyone in your family suffered from heart disease? Do you suffer from epilepsy? If you have any known medical conditions/disabilities not mentioned above, please give details: YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO 4. Equipment Required Towel* £5.00 Water Bottle £3.00 Sweatband £4.00 Headphones £5.00 Gym Bag £3.50 Locker Key Ring £1.00 T-shirt £6.00 Lanyard £2.50 5. Gym Induction Waiver All new members are entitled to receive a free gym induction which will show how to safely use all machines. However should you feel you do not need this service, please complete the gym induction waiver declaration below. I_________________________________ understand that exercise can be physically demanding and if performed incorrectly can cause serious harm. I have opted to not attend the gym induction offered to me and therefore assume all liability for any possible injury caused by the exercises I choose to perform. I acknowledge that I am physically fit and free from any illnesses that may be aggravated by performing exercise. I am a regular user of gyms and I am familiar with most gym equipment. Signed………………………………………………………………. Date……………………………………… 6. Declaration I have seen and understood the terms and conditions of using SportBU. I have had the cancellation and refund policies explained to me. I hereby agree to comply with the Terms and Conditions for use of sportBU centre as stated above. I have, to the best of my knowledge, provided accurate information regarding my current health status. I will inform sportBU of any medical changes that may affect my ability to participate in activities/facilities within sportBU. Signed: ___________________________________________Date:__________________ _____ For office use only Induction Date & Time: Amount Paid: Staff initial: Cash/Cheque/Card: Terms & Conditions These Terms and Conditions form the basis upon which sportBU provides the gym membership to you. By applying for sportBU’s gym membership you are agreeing to be bound by these Terms and Conditions. In these Terms and Conditions, the following definitions shall apply: Bournemouth University (BU): Bournemouth Higher Education Corporation, Talbot Campus, Fern Barrow, Poole, Dorset, BH12 5BB; BU: any person student, staff, or alumni of Bournemouth University or Arts University Bournemouth, or student of a Partner College (see below); Community: any person who does not fall within the BU category above; Corporate: any person who works for an organisation that has a pre-arranged corporate deal with sportBU; Partner College: Weymouth College, Bournemouth and Poole College, Bridgwater College, Kingston Maurward College, Wiltshire College Salisbury, Yeovil College, Anglo European College of Chiropractic, West London College, and The BRIT School; sportBU: the sports department of Bournemouth University; Terms and Conditions: this document as amended from time to time; Membership Term: BU annual memberships are for one academic year, commencing on 1st September and ending on 31st August inclusive, each year. Community/Corporate memberships are for a period of 12 calendar months commencing on and including the date of payment. Upon the expiry of this period, your membership shall automatically terminate. BU memberships purchased for a term are for academic terms, finishing dates are 24th December 2013, 4th May 2014 and 31st August 2014. Community memberships are per quarter (3 months) commencing on and including the date of payment. Payment: Payment must be made in full, in advance and in cleared funds by credit or debit card, cash or cheque at the time of submitting this form. Staff members of Bournemouth University may also pay for their membership through salary deduction, details of which are available from sportBU. sportBU may require proof of your BU status and shall be entitled to request evidence of this. To join you must be aged 18 or over, or 16 with a signed parental consent, and provide sportBU with a completed membership form and full payment. Your membership type and type of user is set out at box 2, above, or as selected by you at the time of membership. Cancellation Rights If you are unhappy with the service offered by sportBU for any reason within the first 7 days of becoming a member, you are entitled to a full refund of any membership fees paid upon producing written evidence to sportBU of your membership, date of joining and payment (receipt). This period is 14 days for those memberships purchased on-line. Your termination rights: you may terminate your membership and sportBU shall refund, on a pro rata basis, the remainder of your membership: o where sportBU is in material breach of these Terms and Conditions; or o due to genuine and relevant medical reasons (for example, illness or injury); or o where you are no longer a student or staff member of Bournemouth University (BU members only); or o where your main residence changes and your new place of residence is more than a 20 minute drive from sportBU, as measured by an established route planner operator. In such circumstances, termination shall be effective either: from the date of breach; or upon production of satisfactory written evidence on the grounds of termination, for example a professional medical certificate, proof of address, termination of BU status. Termination by sportBU: sportBU may terminate your membership immediately and at any time without further liability to you: o if in sportBU’s reasonable opinion your continued membership is, or is likely to be, injurious to the character and interests of sportBU or any other member, for example but not limited to, where your behaviour is abusive, violent, disruptive or threatening; or o you breach any of these Terms and Conditions; or o you let other people use your membership card to access sportBU and its facilities. Membership card and charges Your membership card must be used to gain access through the turnstile at reception and on the gym floor. sportBU may ask you to produce your membership card at any time while you are in the gym. If you repeatedly forget your gym card, sportBU hold the right to request that you purchase a new card before allowing you entry to the gym. Your membership is personal to you and cannot be transferred. You must not loan or lend your membership card or permit its use by anyone else. If you do, we may terminate your membership. The membership card is and remains BU’s property. A £5.00 renewal fee is charged for lost or stolen membership cards. If a valid crime number is provided, the fee will not apply. The normal BU procedures apply for student cards. Facilities and services sportBU reserves the right to make changes to programmes and prices without prior notice. sportBU will be closed on bank holidays and over the Christmas period. sportBU’s opening times within term dates are: o 7.30am – 10.30pm Monday-Friday o 9am – 6pm Weekends sportBU’s opening times within University breaks are: o 7.30am – 8.30pm Monday-Friday o 9am – 6pm Weekends Some of sportBU’s facilities and equipment may not be available during Bournemouth University’s examinations, graduations & conferences. sportBU will be closed for 1 day in September for annual staff training sportBU shall take reasonable steps to bring to your attention which facilities are not available for use and when. You shall take reasonable care of the facilities and equipment at your disposal and you shall be liable for any damage to sportBU’s property where you willingly or negligently cause such damage. Limitation of liability – YOU MUST READ THIS CAREFULLY AND UNDERSTAND THIS You acknowledge that there is an inherent risk of injury (including permanent injury and even death) when undertaking exercise and that you understand the dangers and risk in undertaking physical exercise. Including but not limited to serious neck and spinal injuries, injury to bones, joints, ligaments, muscles, and tendons. By submitting your membership, you voluntarily assume such risk. You understand and accept that sportBU shall only be liable for personal injury or death where this arises from sportBU’s, its employees’, or its subcontractors’ negligence. sportBU shall not be liable, whether in tort, contract, law or otherwise, for any losses including: o loss of income or revenue, loss of profit, loss of business, loss of anticipated savings or loss of data. sportBU’s liability shall be limited to: o £50,000,000 for any one event; and o losses, damages and injury which are reasonably foreseeable. Nothing in these Terms shall limit or restrict sportBU’s liability for: o death and / or personal injury arising from sportBU’s negligence or the negligence of sportBU’s employees, agents, or subcontractors; or o fraudulent misrepresentation. Your belongings, lockers and parking Bags and personal belongings are not permitted in sports areas and should be stored in lockers. Free self-coded lockers are available in the corridors and changing rooms. Parking on Bournemouth University’s campus is restricted on weekdays between 8.30am-4.30pm. Parking tickets can be purchased within the car park. Data Protection You consent to sportBU, whether directly or through an intermediary, processing your personal information for the purposes of membership. You are responsible for notifying sportBU of any changes to your personal information. Things to Know – The Training Zone Gym 24 hours notice is required to cancel an induction. Failure to do so will result in a £5.00 cancellation fee being charged. Appropriate sportswear must be worn at all times. Sports trainers must be worn, no jeans and no flip flops. It is compulsory to bring a towel into The Training Zone gym for hygiene purposes. No food or protein shakes to be consumed up in the gym facilities or poured down the water fountains. Secure bottled drinks to be used only. Members are expected to return all equipment to the relevant storage areas after use. Things to Know – The Group Fitness Programme Due to limited places, please pre book ALL group fitness classes at sportBU reception or on-line. Classes can be booked up to 7 days in advance. Please arrive on time for your class. If you are more than 5 minutes late for your class, admission will be refused. Please ensure you check in and pick up your receipt for your class. For pay-as-you-go customers, refunds will only be issued when the participant gives more than 24 hours notice to cancel a class. Please inform sportBU asap if you are unable to attend a class. Customers that fail to cancel will have this noted on their memberships. 3 ‘no shows’ will result in you being unable to book classes in the future. Please note the Group Fitness timetable will reduce during non-term time. The timetables will be advertised on the website and in sportBU’s reception. General Notices under these Terms and Conditions must be in writing and addressed to sportBU and sent by recorded delivery. sportBU shall not be in breach or liable for the non-performance or delay in performing its obligations under these Terms and Conditions resulting from events, circumstances or causes beyond sportBU’s reasonable control. These Terms and Conditions shall constitute the entire agreement between you and sportBU. Each party agrees that it shall have no remedy in respect of any representation or warranty (whether made innocently or negligently) that is not set out in these Terms and Conditions. No party shall have any claim for innocent or negligent misrepresentation based upon any statement in these Terms and Conditions. These Terms and Conditions and any dispute or claim arising out of or in connection with it or its subject matter or formation (including non-contractual disputes or claims) shall be governed by and construed in accordance with English Law. The courts of England shall have non-exclusive jurisdiction.