MEMBERSHIP APPLICATION

                      Check √ one:           OCS District Resident                     Non-Resident

Member:                                                                         Date of Birth:                                             

Address:                                                                                                                                          

Phone: Home (    )                                                         Cell (     )                                                     

E-Mail Address:                                                                                                                               

Emergency Contact:                                                    Phone              Relationship                         

Medical Concerns                                                                                                                          

                              (List any medical concern necessary to provide medical attention in case of an emergency)

Walking Track Membership Only               

Fitness Center Fee Structure (July 1 – June 30^th) 

            $40.00 – Single Membership                                                                         

            $60.00 – Couples Membership                                                                      

            $75.00 – Family Membership                                                                        

 Fitness center and walking track hours of operation and class offerings will be posted on the school website www.onekama.k12.mi.us

CONDITIONS OF MEMBERSHIP

Members Health:  The applicant is in physically sound condition and they understand that participation in aerobics and other exercise and fitness equipment, or any other use of the Onekama Consolidated Schools Fitness Facility, carries a potential risk of injury or illness.  The applicant further understands that neither the Onekama Consolidated Schools assumes any responsibility for any such injury or illness.

Member Conduct and Right to Use the Facility:  The applicant agrees to abide by all policies, rules, codes and procedures of the Onekama Consolidated Schools Fitness Facility, and they understand that failure to act in accordance with such policies, rules, codes and procedures may result in the suspension or revocation of membership privileges.  

Criminal History:  The applicant acknowledges that it is the policy of Onekama Consolidated Schools Fitness Facility to deny or terminate membership with respect to any individual convicted of a sexual offense, and that the Onekama Consolidated Schools Fitness Facility will periodically check its membership records for sex offense histories.

Property Loss:  The applicant understands that Onekama Consolidated Schools is not responsible for personal property lost, damaged, or stolen while using the Onekama Consolidated Schools Fitness Facility.

Photograph Permission:  The applicant hereby gives permission for the Onekama Consolidated Schools Fitness Facility to take the picture or any person covered by this application for use in the membership program.

Insurance:  The applicant understands that Onekama Consolidated Schools does not provide any accident or health insurance for its participants, and further understand that it is their responsibility to provide such insurance coverage.

Signature (Student)                                             Printed Name                                      Date

Signature (Adult)                                                Printed Name                                      Date

WAIVER AND RELEASE OF LIABILITY

I wish to participate in or otherwise utilize or observe the facilities, services, equipment, programs or activities of the Onekama Consolidated Schools Fitness Facility for any or all purposes.  In return, I acknowledge and agree that:

I have had an opportunity to inspect the Center facilities and equipment or immediately upon entering or participating will inspect such facilities and equipment and have accepted the facilities, equipment and programs as being safe and reasonably suited for the purposes intended.  

I release the Onekama Consolidated Schools and its Board of Education, together with its/their Board members (both individually and collectively), officers, directors, administrators, employees, agents and volunteers (collectively the “Releasees”), from any and all claims and liability for any loss, damage, illness or injury (up to and including death) which may occur to or be sustained by me during my presence at, participation in, or use of any program, activity, service, equipment, or facility associated with or comprising part of the Center; and I agree not to bring any legal action against any or all of the Releasees with respect to any such claims, liability, loss, damage, illness or injury.

I agree to indemnify and hold harmless any and all of the Releasees, from any claims, liability, loss, damage, illness, injury, legal costs and attorneys fees incurred by any of the Releasees, arising from my activities and presence in , upon or about the Center.

I am aware of the inherent risks of participating, observing or using the facilities and activities of the Center, and I assume full responsibility for any and all of the risks.  

I do not know of any physical or mental health condition that would prevent me from, or could get worse by, my participation in or use of the facilities, equipment, programs, activities or services at the Fitness Facility. 

I have read this release, understand it, and freely sign it.  I also agree that this release is binding upon my legal representatives or anyone who tries to claim through me.  

Signature (Student)                                             Printed Name                                      Date

Signature (Adult)                                                Printed Name                                      Date            

Onekama Consolidated Schools

Walking Track / Fitness Center Policy

1. In an effort to enable everyone to enjoy the walking track and fitness facility, please read through and abide by the following guidelines:

2. No drugs, tobacco or alcoholic beverages are permitted on any school district property.

3. Gum, candy, food or drinks are not permitted in the walking track / fitness facility areas (exception will be closed container bottled water).

4. All participants must complete a Fitness Center Orientation to ensure proper understanding and use of fitness equipment prior to the issuance of a fitness center swipe key.

5. Street shoes will not be permitted on the walking track or fitness equipment.  Clean / appropriate exercise shoes must be worn at all times.

6. Middle and high school students only will be permitted in the fitness facility after school hours / outside of sports practices through purchased membership. Middle school students will be allowed membership use under direct parental supervision and high school students will be allowed membership without direct parental supervision.   

7. An identifying swipe key will be issued upon registration.  Entrance and exit times from the facility will be monitored by the swipe key as well as security cameras.  Swipe keys are not to be shared.  Member shall be held solely responsible for immediately reporting to the district a lost or stolen card.  Member shall incur a replacement cost for lost or stolen card.  Photo identification could be requested periodically to verify membership. 

8. Use during summer vacation, holidays, or during other vacation periods shall not conflict with building cleaning and renovating programs and will depend on the availability of building service personnel for supervision.

9. Responsibility for complying with the rules and regulations concerning use of District facilities rests with the authorized individual user, and any infractions of the above regulations may be grounds for refusing to grant subsequent use of District facilities.

 Walking Track Hours               Membership Renewal Form

Contact Persons: Mary Bergren: mbergren@manistee.org / Cindy Kadzban lovebiking@charter.net

  www.onekama.k12.mi.us