Platinum-Gym.com

To join Platinum Fitness Center please follow our 2 step procedure:
Step 1:complete this order form and submit it.
Step 2: call us directly at (718) 897-9111 and read to an employee your credit card information.

Your sign up process is done. When you come in to our gym, the only thing you will need to do is to sign your application and you are ready to start your work out.

You can also print and fax us your completed application: Print applicaton



MEMBERSHIP
Special
NAME/ADDRESS

Last Name Letter:
Today's Date:
First Name/Last Name:
Telephone:
Email:
Birthdate:
Address:
City/State:
Zip Code:

MEDICAL BACKGROUND

Name of Doctor:
Telephone Number:
Are you currently taking medication?		Yes No
If Yes please list them:

When was your last physical examination?
Contact in case of emergency: (Name, Telephone, Number)

Have you read Liability Weaver, Terms & Conditions?		Yes No

Liability Weaver:
It is expressly agreed that all use of the fitness facilities shall be undertaken by a member, at his/her own risk, and Platinum Fitness Center, Inc. shall not be liable for any injuries or damages to any member or be subject to any claim, demand, injury or damages whatever, including, without any limitation, those damages resulting from acts of active or passive negligence on the part of Platinum Fintess Center, Inc., its successors or assignees, as well as its officers, and agents, for all such claims, demands, injuries, damages actions ot causes of actions. It is specifically agreed that Platinum Fitness Center, Inc. shall not be responsible or liable for loss or damamge to any other property or any member by any other member or his/her guest is the sole responsibility of the other offending party.

Terms and Conditions
The person whose signature appears below agrees to abide by all rules and regulations at Platinum Fitness Center, Inc. in effect or to become effective at any future date.

1. Membership is non-transferable.	9. Sneakers or athletic shoes must be worn at all times
2. Membership recipient must be presented upon entry and each member must sign in. Photo I.D. may be required.	10. Suitable exercise clothing must bee worn while working out.
3. No refunds on membership will be allowed.	11. A shirt must be worn while training, except when posing.
4. Lockers are for daily use only. Locks left overnight will be removed by club personnel, and contents discarded.	12. Alcoholic beverages and smoking are strictly prohibited.
5. Any abuse of equipment will not be tolerated.	13. Loud or abusive language will not be tolerated.
6. Gym bags are not permitted on the exercise floor.	14. Nothing other than in-house products will be sold on the premises.
7. Equipment must be replaced after use.	15. Improper behavior, misuse of equipment or violation of gym rules may result in immediate termination of membership.
8. No barbells or dumbbells are permitted on padded vinyl benches