Student ID # 1651 Lexington Ave, Astoria, OR 97103 Community Education Today s Date: Bandit Community Fitness Bandit Community Fitness offers access to the College s weight room, cardio room and running track. Members may use the facilities during posted open hours when not conflicting with academic classes. Please check one level of membership: Community Member $99 / FIT085067-D1 Veteran $60 / FIT085067-D2 Alumnus $55 / FIT085067-D3 Senior $60 / FIT085067-D4 (age 62+) (Alumnus is defined as having graduated with a certificate or associate degree from Clatsop Community College) Legal First, Middle and Last Name* (please print) Date of Birth* Mailing Address* Address Line 2 Phone* City State Zip Code Email* Term (please circle one) Summer 20 Fall 20 Winter 20 Spring 20 FINANCIAL RESPONSIBILITY: I understand that by registering for a class at Clatsop Community College I have incurred a legal obligation to pay all tuition and fees and any other charges relating to my enrollment at the College. I understand that unless I officially withdraw from my classes that I am obligated to make payment by the due date published in the relevant schedule. If I do not make payment, make arrangement for payment, withdraw from my classes by the required date, I will also be responsible for addition late charges and collection and attorney s fees. *Required information Participant Signature Date If under 18, parent must also sign Turn this form and the Liability Release Form in at the Welcome Center in Columbia Hall.
(Please print) Participant Name: Home Phone: Emergency Contact Name(s) and Number: Activity: Clatsop Community College Fitness: Liability Release Form (Adult 18+) Address: for Community Education and Academic classes Clatsop Community College (College) requests anyone participating in the Activity to sign and have parents/guardians sign, if applicable, the following Liability Release Form and return it to the College. The Activity is not sponsored by the College. The facilities, equipment, and exercise programs utilized by the College have been designed and instituted to provide exercise benefits and enjoyment without compromising the health and safety of participants. In physical fitness programs, certain dangers and conditions may occur, including but not limited to, muscle and joint injury, strains, sprains, bruises, hernias, and other injuries. These include injuries inflicted by the following: all manner of injury resulting from falling and impacting the floor or wall, failure of exercise equipment, injuries caused through inappropriate technique or overuse, injury resulting from increased heart rate, blood pressure and strenuous physical activity, which may include shortness of breath, lightheadedness, or death. I understand that participation in this Activity will expose me to risks of injuries and that I will be engaging in Activity without class supervision. Some of these risks are foreseeable, but some are unforeseeable. Examples of risks include physical injury, emotional injury, property damage, economic loss, noneconomic loss, and deprivation of rights, privileges, and immunities. Also, some of these risks cannot be eliminated due to the nature of the activities. I understand that these risks could cause harm to me, my property, and harm to other persons. I recognize that my participation is not required by the College. I recognize the dangers inherent in the Activities, but I am willing to participate in the Activity. As consideration for my right to participate in the Activity, I voluntarily agree to waive and discharge any and all claims against the College and release it from liability, up to and including claims for any negligent actions of the College or its employees or agents, to the fullest extent allowed by law, for myself, my estate, my heirs, my administrators, executors, assignees, and successors. I also agree to release, exonerate, discharge and Hold Harmless the College, its Board of Directors, the individual members thereof, and all officers, agents, employees, volunteers, and representatives from liability, claims, causes of action, or demands, including attorney fees, arising out of injuries of any kind to me, my property, or losses of any kind which may result from or in connection with my participation in the Activity, up to and including injuries stemming from the negligent actions of the College or its employees or agents. I further certify and represent that I have the legal authority to waive, discharge, release, and hold harmless the released parties. I, the undersigned, acknowledge that it is my responsibility to procedure or otherwise obtain accident and medical insurance coverage for my participation in this Activity. I further acknowledge that I am responsible for following the rules and regulations of the College found on the Patriot Hall webpage www.clatsopcc.edu/patriothall with regard to participation in the Activity. I acknowledge that if I fail to follow the College s rules, I may lose my right to participate in the Activity and may forfeit any fees paid to participate in the Activity. This Agreement is intended to be as broad and inclusive as is permitted by law. If any provision or any part of any provision of this Agreement is held to be invalid or legally unenforceable for any reason, the remainder of this Agreement shall not be affected thereby and shall remain valid and fully enforceable. I certify that I have read this document and fully understand its contents. I freely and voluntarily assume all risks of participation in this Activity on my behalf. Signature of Participant: Date: Clatsop Community College Fitness: Liability Release Form (Adult)
Clatsop Community College Fitness: Liability Release Form (Participant age 16-17) (Please print) Minor Participant Name: Home Phone: Parent/Guardian Name(s) and Number(s): Activity: Address: for Community Education and Academic classes Clatsop Community College (College) requests anyone participating in the Activity to sign and have parents/guardians sign, if applicable, the following Liability Release Form and return it to the College. The Activity is not sponsored by the College. The facilities, equipment, and exercise programs utilized by the College have bene designed and instituted to provide exercise benefits and enjoyment without compromising the health and safety of participants. In physical fitness programs, certain dangers and conditions may occur, including but not limited to, muscle and joint injury, strains, sprains, bruises, hernias, and other injuries. These include injuries inflicted by the following: all manner of injury resulting from falling and impacting the floor or wall, failure of exercise equipment, injuries caused through inappropriate technique or overuse, injury resulting from increased heart rate, blood pressure and strenuous physical activity, which may include shortness of breath, lightheadedness, or death. I understand that participation in this Activity will expose me or my child/participant to risks of injuries and that the participant must be under parental supervision while engaging in Activity. Some of these risks are foreseeable, but some are unforeseeable. Examples of risks include physical injury, emotional injury, property damage, economic loss, and deprivation of rights, privileges, and immunities. Some of these risks cannot be eliminated due to the nature of the activities. I understand that these risks could cause harm to participant, his/her property, and harm to other persons. I recognize that the minor s participation is not required by the College. I recognize the dangers inherent in the Activities, but I am willing to participate and I am willing to allow Student to participate in the Activity. Both minor participant and I voluntarily agree to waive and discharge any and all claims against the College and release it from liability, up to and including claims for any negligent actions of the College or its employees or agents, to the fullest extent allowed by law, for myself, participant, our estates, our heirs, our administrators, our executors, our assignees, and our successors. I also agree to release, exonerate, discharge and Hold Harmless the College, its Board of Directors, the individual members thereof, and all officers, agents, employees, volunteers, and representatives from liability, claims, causes of action, or demands, including attorney fees, arising out of injuries of any kind to me, participant, or to our property, or losses of any kind which may result from or in connection with Student s participation in the Activity, up to and including injuries stemming from the negligent actions of the College or its employees or agents. I further certify and represent that I have the legal authority to waive, discharge, release, and hold harmless the released parties on behalf of Student. I, the undersigned, acknowledge that it is my responsibility to procedure or otherwise obtain accident and medical insurance coverage for Minor Participant s involvement in this Activity. I further acknowledge that Minor Participant is responsible for following the rules and regulations of the College found online at www.clatsopcc.edu/patriothall with regard to participation in the Activity. I acknowledge that if participant fails to follow the College s rules, participant may lose the right to partake in the Activity and may forfeit any fees paid to participate in the Activity. This Agreement is intended to be as broad and inclusive as is permitted by law. If any provision or any part of any provision of this Agreement is held to be invalid or legally unenforceable for any reason, the remainder of this Agreement shall not be affected thereby and shall remain valid and fully enforceable. I certify that I have read this document and fully understand its contents. I freely and voluntarily assume all risks of participation in this Activity on my behalf and/or participant s behalf. Signature of Minor Participant: Date: Signature of Parent/Guardian: Date: Clatsop Community College Fitness: Liability Release Form (Participant age 16-17)
PATRIOT HALL RULES AND REGULATIONS General Rules and Regulations The following general rules and regulations apply to all users of the CCC s fitness facilities: 1. The Fitness Center Fall/Winter/Spring hours are: Monday-Friday: 6:00am-10:00pm Saturday: 8:00am- 5:00pm Sunday: 8:00am-5:00pm Summer hours: Monday-Thursday: 6:00am-8:00pm 2. All non-student users are required to complete and sign a Fitness Registration Form and Waiver prior to using the fitness facilities. Access to the facility will not be permitted until the form and waiver is completed. No Guests are allowed. No Exceptions. 3. Users must check-in with their ID card upon entering the fitness facilities. 4. Attire: Proper fitness attire is required in weight and cardio rooms. Street clothes (jeans, khakis, etc.) are not permitted. Shirts (t-shirts, sweatshirts, full length tank tops). 5. Shoes (sneakers and shoes with non-marking soles) are required at all times on the track and in facilities. Sandals and flip-flops are not appropriate footwear. If you are not wearing the proper attire the staff has the right to refuse use of the facility until you have the proper attire. Attire should cover all areas of the back and mid-section that may come in contact with fitness equipment and be clean before use. This is for your protection and prevention of skin infections. 5. Everyone is expected to practice proper Fitness Facilities etiquette. (a) Returning all equipment to the proper location after each use (re-rack weights). (b) Wiping down all the pads and surfaces that you come into contact with. (c) Sharing equipment. If you are doing multiple sets, allow others to use the equipment in between your sets. No resting on equipment between sets. Adhere to the time limits on equipment set by the Fitness Center. (d) Practicing personal hygiene by using deodorants and wearing clean workout clothes. (e) Avoiding the Fitness Facilities if you are feeling ill or believe you have a contagious illness. (f) Not using profanity, offensive language or shouting. If you refuse to adhere to this rule you will be asked to leave. (g) Using the equipment properly. If you are unsure or need instruction, please review equipment videos on the Patriot Hall page on the website or contact a staff member. (h) Not interrupting fitness center staff who are working one-on-one with a member or if they are instructing a class. (i) Being on time for scheduled classes and check-in at the front desk. (j) Exiting the fitness center at closing time. 6. Personal Training and Fitness programs being instructed and conducted by anyone other than CCC Staff is prohibited. Those not following this policy will be warned. Repeat offenders will be subject to possible loss of membership privileges.
7. The fitness equipment should always be used properly as recommended by the manufacturer. Always leave the equipment in proper working condition. If you are unsure of how to use equipment, please review the equipment videos on the Patriot Hall page of the website or ask a fitness center employee. 8. Free Lockers are for day-use only and are intended for use only while you are working out in the fitness center. Designated lockers may be rented on a first-come/first-serve basis, per semester. For more information on locker use, please see a CCC Bookstore staff member. 9. Fitness Center employees are not responsible for personal property that is lost, stolen, or damaged due to vandalism or any other cause. You are encouraged to lock up all belongings in the free day use only lockers. 10. No food and gum will be consumed in the Fitness Facilities other than locker rooms or designated eating areas. Beverages must be in spill-proof containers. 11. Posted or regulated time limits for using the Fitness Center s facilities and equipment will be respected. In periods of heavy use, you may be asked to limit your time in a particular area to allow other members an opportunity to use the facilities and equipment. WEIGHT LIFTING AND EXERCISE EQUIPMENT AREAS The following rules and regulations apply to the users of the Fitness Center s weight lifting and exercise equipment areas: 1. For safety reasons; bags, jackets, and coats are not allowed in the weight lifting or exercise equipment areas. All items should be placed in lockers. 2. There is a maximum of 30 minutes per session on any cardiovascular equipment during peak hours. If you are doing multiple sets on the circuit machines during peak hours (6:00am to 8:30am, 11:00 am to 1:00 pm, and 3:00 pm to 7:00 pm.) please be considerate and allow others to use the equipment between your sets. 3. Each piece of equipment used must be wiped clean after use. 4. Users must return bars/weights to their proper place/racks immediately after use. 5. Weight belts are not allowed on exercise equipment if the belt buckle makes contact with the equipment upholstery. 6. Keep hands and feet clear of moving parts while machine is in use. Never put hands or feet under weight stacks. Place hands and feet only on the hand grips and foot pads provided. 7. Do not operate equipment if it has loose or damaged parts. Report repair needs to the staff. Do not make repairs yourself. 8. Do not drop weight stacks, plates, dumbbells or other free weight equipment. Failure to do so will result in a warning. Repeat offenders will be asked to leave the fitness center for not complying with fitness center policies. These rules and regulations are designed to make the Fitness Facilities a safe and enjoyable place for all members. Violations of these rules and regulations can result in suspension or termination of your Fitness Facilities membership. These rules and regulations may be modified or amended at any time without prior notice.