Youth Small Group Contract


Membership Type Youth Small Group
I consent to receive information from Peak-topia via email.*
I agree to give Peak-topia permission to photograph and/or record video for purposes of social media and advertising.
We use social media to give fitness and health tips, youth program specific information and other details concerning the gym. If you use Social Media please follow us:

2. MEMBERS DECLARATION & PAYMENT DETAILS. Before signing this document, I have read, understand, and hereby agree to the terms and conditions of membership as defined in this membership form and know that it affects my legal rights. I agree to pay the amount written below each month until I cancel my membership. Peak Performance Fitness & Nutrition, LLC (Peak Performance) must receive (from member) or give (to member) a 30-day written notice to alter this agreement.

3. ASSUMPTION OF RISK. I understand that there are dangers, hazards, and risks of injury or damage, some of which are inherent in the use of Peak Performance’s premises, facility, equipment, services, activities or products.

A. Use of Premises and Services. I understand that Peak Performance’s premises, facility, equipment, services, activities or products can include but not limited to: fitness floors, fitness equipment, personal training services, group fitness classes, weight loss or nutritional programs, lobby or sidewalks.

B. Risks. I understand that the dangers, hazards, and risks of injury or damage in the use of Peak Performance

C. Premises and Services (“Risks”) may include but are not limited to: slips, trips, collisions, falls, and loss of footing or balance, including “slip and falls” and falls from fitness equipment; equipment failure, malfunction or misuse.

D. Injuries. I understand that such injuries or damages may include but are not limited to major or minor personal, physical, bodily, emotional, mental, economic, property or other types of injuries or damages to me or guests, including but not limited to: death, paralysis, heart attacks, heat stress and/or heat stroke, dehydration, concussions, torn or damaged muscles or ligaments, broken bones, allergic reactions, sprains, bruises, scrapes.

E. I fully understand, and voluntarily and willingly assume, all of the risks that may or can arise out of participating as a Member of Peak Performance, including but not limited to the activities, use of equipment, field or facilities, the acts of others or the unavailability of emergency care, as well as those risks described in the preceding paragraphs.

Additionally, I hereby fully consent to emergency medical care to be rendered by competent medical physicians in the event that I and/or my minor children should require such attention during participation as a member.

4. WAIVER OF LIABILITY AND INDEMNIFICATION. On behalf of myself, spouse/partner, children/Minor Members, I hereby I voluntarily and forever release and discharge Peak Performance from, covenant and agree not to sue Peak Performance for, and waive, any claims, demands, actions, causes of action, debts, damages, losses, costs, fees, expenses or any other alleged liabilities or obligations of any kind or nature, whether known or unknown for any Injuries to me, Minor Members or Guests. My agreement to indemnify and hold Peak Performance harmless means that I will pay any settlement, judgment, or other damages, fees of costs of any type incurred by Peak Performance to resolve the claim.

5. ADMINISTRATION. * Let your coaches know if you can’t make a session. * Appropriate covered footwear & a shirt must be worn at all times while in the gym facility. We would appreciate only shoes free from outside debris to be worn inside the gym (i.e. no mud, dirt, rocks, etc.) * Bring your own mat to the gym * Keeping our clients healthy is a goal of PEAK. Please be considerate of your health and other gym members health by not coming to the gym if you are contagious. * Memberships are not refundable or transferable.

6. DAMAGE TO COMPANY PROPERTY. In the event that any damage to equipment and/or facilities occurs as a result of my or my minor children's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness.

7. LEGAL RIGHTS. I acknowledge that I am surrendering valuable legal rights in this document and I further agree that this agreement shall be governed by and interpreted in accordance with the laws of the State of North Carolina.

8. SEVERABILITY. In the event that any provision contained within this document shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this document is invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.

Physical Activity Readiness Questionnaire (PAR-Q)

Health History: Please read each question carefully. Initial in the space provided indicating that you understand what is recommended Physical activity should not be hazardous for most people. The questions are designed to identify those who should consult a physician prior to beginning a program of physical exercise.

Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?*
Do you feel pain in your chest when performing physical activity?*
Have you experienced chest pain when NOT performing physical activity in the last month?*
Do you lose your balance because of dizziness or have you lost consciousness recently?*
Do you have any bone or joint problems (back, knee, hip, etc.) such as arthritis, which could be aggravated through physical activity?*
Is your doctor currently prescribing you medicines for high blood pressure or a heart condition?*
Is there any reason why you should not participate in physical activity?*
Have you consulted your physician regarding increasing your physical activity and performing a fitness assessment?*
If no, will you consult your physician prior to starting at Peak Performance?
Lifestyle Questions
Do you eat 3 meals per day?*
Do you Eat 5 Servings of Fruits/Veggies a Day?*
Do you Eat Fast Food?*
Do you Drink Soft Drinks?*
Do you Take Supplements?*
Get 7-8 Hours of Sleep Daily?*
Rate your Motivation *1= lowest; 10= highest