Membership Application

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1Member details

2Membership & payments

3Terms & security

4Safety & declaration

5PAR-Q & health declaration

Member details

Private members gym

Membership application

A1 Leisure is a private members-only gym limited to just 75 members. We aim to provide a clean, secure and uncrowded environment where members can enjoy training with 24-hour access.

Membership is based on trust, respect and personal responsibility. Water and refreshments are available on a donation basis and are there for your enjoyment. Please help us keep this facility welcoming for everyone.

Full name *

Address *

Postcode *

Date of birth *

Telephone number *

Email address *

Emergency contact name *

Emergency contact number *

Date joined

Membership & payments

Membership fees

Monthly membership: £27.50 per month
Key fob deposit: £10, refundable when the key fob is returned
Payment date: Standing order due on the 1st of each month

Failure to maintain payments may result in suspension or cancellation of membership.

Key fob deposit

Transfer £10 using the details below.

Account name: A1 Leisure
Account number: 14059610
Sort code: 08-71-99
Reference: KEYFOB + YOUR NAME

Monthly standing order

Set up a standing order for £27.50 using the same account details, with your name as the reference and the 1st of each month as the payment date.

Terms & security

Membership terms

Membership fee review

A1 Leisure reserves the right to review membership fees. Members will receive a minimum of 30 days’ written notice of any change.

Cancellation

Either party may cancel membership by giving one calendar month’s written notice by email, message or letter. Membership fees remain payable during the notice period. Any outstanding balance must be paid and the key fob returned.

Access & security

Membership and key fobs are personal and non-transferable. Members must not share, lend or duplicate a key fob, allow non-members into the facility, permit another person to use their membership, or circumvent security. Please make sure doors close securely behind you.

Unauthorised access

Any member found allowing non-members access, sharing a key fob or circumventing security will have membership terminated immediately, without refund, and may be refused future membership.

CCTV

The premises are monitored by CCTV 24 hours a day for security, safety, insurance and crime prevention. By joining, you consent to CCTV monitoring while on the premises.

Member responsibilities

Use equipment with care and return weights after use.
Keep the gym clean and tidy, wipe down equipment and dispose of rubbish.
Respect other members and report damage or faults.
Help maintain a friendly, welcoming atmosphere.

Repeated failure to meet these responsibilities may lead to withdrawal of membership.

Safety & declaration

Safety and membership declaration

24/7 access & unstaffed periods

The gym may be unstaffed and you may train alone. You do so at your own risk. Exercise caution, carry a mobile phone and call 999 in an emergency.

Minimum age

Members must be aged 16 or over. Proof of age may be required. Anyone under 18 must have consent from a parent or guardian.

Liability

Physical exercise carries inherent risks. You participate voluntarily and at your own risk. A1 Leisure is not responsible for injury, loss or damage except where caused by proven negligence. You are responsible for using equipment safely. Your statutory rights are unaffected.

Waiting list

Membership is capped at 75 members. When full, applicants may join a waiting list in application order. Failure to make payment when a place is offered may result in losing that place.

Member declaration

I have read and understood this agreement.
I agree to comply with its terms.
I understand that one calendar month’s notice is required to cancel.
I understand that providing non-member access may result in immediate termination.
I consent to CCTV monitoring.
I use the facility at my own risk.

Electronic signature — type your full name *

Typing your name records your electronic acknowledgement.

Declaration date *

PAR-Q & health declaration

Physical Activity Readiness Questionnaire

PAR-Q

Please answer every question honestly. If you answer YES to any question, seek medical advice before exercising.

1. Has a doctor ever advised you not to exercise because of a heart condition? *

2. Do you experience chest pain during physical activity? *

3. Have you experienced chest pain while not exercising in the past month? *

4. Do you experience dizziness, fainting or loss of balance? *

5. Do you have a bone, joint, muscle or back problem that could be aggravated by exercise? *

6. Are you taking prescribed medication for blood pressure or a heart condition? *

7. Have you been advised by a healthcare professional to restrict physical activity? *

8. Do you have any other medical condition that could affect your ability to exercise safely? *

If you answered YES to any question, please provide details

Only include information relevant to exercising safely.

Health declaration

I declare that the information provided is accurate and complete to the best of my knowledge.

I understand that participation in physical exercise carries risks and that I am responsible for seeking medical advice where appropriate.

Print name *

Health declaration electronic signature — type your full name *

Health declaration date *