Employee Gym Membership Application - McLaren Greater Lansing | McLaren Health Care Documents and Links

Gym Membership Application - McLaren Greater Lansing

*Indicates required information

Contact Information

Employee First Name: *

Employee Last Name: *

Address *

City *

Zip Code *

Cell Phone Number: *

Work Phone Number: *

Employee Number: *

Email Address: *

Type of Membership (check all that apply): *

Emergency Contact

Emergency contact first name: *

Emergency contact last name: *

Emergency contact phone number: *

Emergency contact relation to you: *

Waiver of Liability Claims

In consideration of my use of the exercise equipment and facilities provided by the McLaren Wellness Center, I expressly agree and contract, on behalf of myself, my heirs, executors, administrators, successors and assigns, that the company, including all subsidiaries and its insurers, employees, officers, directors, and associates, shall not be liable for any damages arising from personal injuries (including death) sustained by me in, on, or about the premises, or as a result of the use of the equipment or facilities, regardless of whether such injuries result, in whole or in part, from the negligence of McLaren Wellness Center.

By the execution of this agreement, I accept and assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me and I hereby fully and forever release and discharge the company, including all subsidiaries, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use of said equipment and facilities.

I expressly agree to indemnify and hold the company and all subsidiaries harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages sustained by me.

I understand that using the exercise and wellness facility will result in my exposure to higher-than-normal risks of injury to person or property.
I represent that I have no health or physical problems, which would interfere with my safe use of the exercise and wellness facility provided by McLaren.
I agree that I am responsible for my own safety.
I agree to assume and accept the dangers, which are inherent in the use of the exercise and wellness facility provided by McLaren.
I agree that I will not allow any other person to use my membership card or to gain access to the wellness facility provided by McLaren.
I further agree that if McLaren or their respective agents, representatives, employees, related entities, successors or assigns, are sued by anyone else because of my conduct in using the wellness equipment, I will indemnify McLaren for any and all damages or costs they may incur, including actual attorney fees.
I understand that I must be at least eighteen years of age to be eligible for an individual membership in the Wellness Center.
I acknowledge that McLaren will not allow me to use the Wellness equipment unless I sign this release.

Rules and Regulations

Food is not allowed in the Health and Wellness Gym.
Employees must swipe their badge when entering the gym.
Employees may only use their badge to gain entrance to the gym.
Employees must wipe down all gym equipment after use with the provided hospital approved sanitizer wipes.
Please be respectful to the staff who work in the gym. Please don’t use computers and/or sit at the workstations.
Violations of any rules can lead to automatic termination of gym privileges.
Membership automatically ends upon termination of the employee.
Employees must adhere to the CMS masking guidelines during patient care hours (7 a.m. – 6 p.m.)

Policies and Terms

Employee Member(s) Packages:

Employee ........................................................................FREE

Definitions:

Employee: All employees of McLaren Greater Lansing. Any employee who works for security, McLaren Home Care, and McLaren Health Care who work solely in the medical center and contracted workers are eligible to apply for membership.

Rule Changes: McLaren may make changes, deletions or additions to the Health and Wellness Center rules, regulations, and fees at any time. Members are required to abide by all rules and regulations.

I HAVE READ AND UNDERSTAND THE AGREEMENT BEFORE SIGNING IT

Employee - Applicant Name: *

Employee - Applicant Signature: *

Authorized McLaren Representative Name:

Authorized McLaren Representative Signature:

Date: *

This membership begins on the date specified and continues until terminated by either the member or McLaren. Please allow 24-48 hours for access to be manually granted to your badge for the employee gym.