Guest Waiver Step 1 of 3 33% ATTENTION:You will be unable to submit the form. Error: No Club Number is associated to the form. Please go to Location Selector to re-apply the location number and continue, thanks.Personal InformationName(Required) First Last Email(Required) Phone(Required)Birthdate(Required) MM slash DD slash YYYY Gender Male Female Street Address City StateAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyomingPreferred Contact Method Call Text Email Fitness InformationHow Did You Hear About Us Former Member Corporate Drive-By or Billboard Employee Referral Social Media Radio Web Search Free Pass Out of Town Guest VIP Week What are your Fitness Goals? Lose Weight/ Body Fat Gain Muscle/ Weight Cardio/ Heart Health Injury Rehabilitation General Health Other ConsentAs a Guest of Fitness Premier, I acknowledge that physical activity and the use of exercise equipment, club facilities, club programs, tanning beds, fitness instruction, and other services could result in illness, injury, or theft of personal property. I hereby affirm that I am a voluntary participant in these activities and assume all associated risks. Furthermore, I release and hold harmless Fitness Premier, along with its officers, staff, agents, and assigns; from all claims should any injury, illness, or loss occur. I am hereby advised to consult a physician before undertaking any exercise program. My signature below indicates that I have carefully read this waiver and agree to its terms and conditions.Terms and Conditions(Required) I Consent to Workout Fitness Premier Clubs is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. If you consent to us contacting you for this purpose, please tick below to say how you would like us to contact you:I agree to receive other communications from Fitness Premier. I agree to receive other communications from Fitness Premier Clubs. You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy. By clicking submit below, you consent to allow Fitness Premier Clubs to store and process the personal information submitted above to provide you the content requested.Signature(Required)HiddenCard Number Take your photo