Member Account #:

5716 W. Hwy 290, #106

Austin, Texas 78735
512.358.8433
PERSONAL TRAINING STUDIO
MEMBERSHIP AGREEMENT
Last Name First Name Middle Initial

Street Address City State Zip

Home Phone Work Phone Cell/mobile/pager

Email Emergency Contact Name Relationship Emergency Contact Phone

SSN# Birth date How did you hear about us?

_________/__________/__________

o MONTHLY MEMBERSHIP : I understand and agree that my monthly membership dues of $________________, will be
automatically drafted from my credit card or bank account each month on the 10th or 25th (circle one) beginning ____/____/____
for a minimum of ______ months.

My automatic payment plan will automatically renew and continue until canceled by me in writing by certified mail. Cancellation
takes effect 30 days from postmark on certified letter. I agree to all membership terms and conditions as outlined below, on the back
page of this agreement, and the Automatic Payment Account Information page if applicable.

o PAID IN FULL MEMBERSHIP : Length of Time Purchased ______________ Expires _____/_____/_____

Initiation Fee: $_______________ Amt. Received Today: $_____________ * Cash * Check * CC

First Month’s Dues: $_______________ Balance Remaining: $_____________ * Payable by following installments

Registration Fee: $_____10.00______ AMOUNT DUE DATE PAYMENT METHOD

Equipment/Product (+ tax): $_______________ I NSTALL #1: $__________ ___/___/___ _______________ * APS DRAFT
I NSTALL #2: $__________ ___/___/___ _______________ * APS DRAFT
TOTAL AMOUNT DUE: $ I NSTALL #3: $__________ ___/___/___ _______________ * APS DRAFT
I NSTALL #4: $__________ ___/___/___ _______________ * APS DRAFT

Late Payment and Default: Should you default on any payment obligation as called for in this agreement, the entire remaining balance plus
any applicable fees shall be deemed due and payable upon demand.. You will be subject up to a $25.00 late fee (plus any applicable tax) for
any unpaid balances and returned checks, bank drafts, credit cards or debit cards due to (but not limited to) the following: NSF’s, closed
accounts, stopped payments, invalid accounts, declined credit card, lost or stolen credit card, holds on credit card, invalid or wrong credit card
expiration dates etc. It is your responsibility to notify AMERICAN PAYMENT SERVICES in writing of any change in your automatic draft
payment method 10 business days prior to your draft date. Any returned\declined credit card transactions will be drafted 10 days after the
initial transaction and will include late fees. We reserve the right to redraft any past dues amounts and\or service fees at any time without
prior notice to you. You grant AMERICAN PAYMENT SERVICES the right to use the account information from any payment method or
payments that you have given to redraft any past due amount and\or late fee.
IF YOU DECIDE YOU DO NOT WISH TO REMAIN A MEMBER OF THIS FITNESS CENTER, YOU MAY CANCEL THIS CON-
TRACT BY MAILING, TO THE FITNESS CENTER BY MIDNIGHT OF THE THIRD (3) BUSINESS DAY AFTER THE DAY YOU
SIGN THIS CONTRACT, A NOTICE STATING YOUR DESIRE TO CANCEL THIS CONTRACT. THE WRITTEN NOTICE MUST BE
MAILED BY CERTIFIED MAIL TO THE FOLLOWING ADDRESS: P.O BOX 130, MARBLE FALLS, TEXAS 78654. ALSO RETURN
ALL CONTRACT COPIES, TEMPORARY CARDS, AND/OR MEMBERSHIP CARD.
NOTICE TO PURCHASER: 1) DO NOT SIGN THIS CONTRACT UNTIL YOU READ IT OR IF IT CONTAINS BLANK SPACES 2).
By signing this contract you certify that you have read, understand and agree to all pages of this contract. 3). This contract is subject to
corporate office approval. No oral representation shall be binding on the health club or its owners.

______________________________________ ______/_____/ 20_____ ___________________________

Member’s Signature Today’s Date Employee’s Full Name (print)
 EVOLVE PERSONAL TRAINING
TERMS & CONDITIONS

Membership Information: If you have any questions regarding your membership, contact Evolve Personal Training. You will be mailed (to the address
you provided on the front) a membership letter containing a copy of this contract along with a membership slide card. You are required to bring the slide card
with you when you come to use the facility. Replacement cards are $10.00.
Rules and Regulations: By signing this contract, you acknowledge the rules and regulations governing the conduct of members and guests, and you agree to
follow them.
Guests: Member shall be entitled to bring a guest or guests to Evolve Personal Training, but only pursuant to such rules, regulations, fees, schedules and/or
charges for such guest or guests as may then be in force by Evolve Personal Training. Evolve Personal Training reserves the right to limit the number of
guests or the number of times any one guest can use Evolve Personal Training facilities and reserves the all rights to exclude any guest whose use of the fa-
cilities, in the sole opinion of Evolve Personal Training, would be detrimental to Evolve Personal Training or any of its Members. No guest may use the fa-
cilities without “signing in” at the front desk and no guest may use Evolve Personal Training or any of its facilities or activities without being accompanied at
all times by the member.
Services: We agree to provide you with use of our facilities and all equipment and amenities which are available to you under the terms of your particular
membership. We reserve the right to add or delete services, amenities, and hours as reasonably warranted.
Freezes: You have the option to freeze your membership up to 6 months at a time. Term memberships paid on a monthly basis may freeze time not pay-
ments. Memberships can be frozen for a $5.00 a month fee.
Initiation Fee: By paying the initiation fee, you are purchasing the privilege of membership to the facility. The initiation fee is considered fully earned upon
commencement of your membership and as a result is non-refundable.
Monthly Dues: Monthly dues represent the cost of having use of the facility available to you for a thirty day period. Dues are considered fully earned the
first day of any thirty day availability period. Funds must be available on the date of payment and after until such payment clears. You will not have use of
the fitness center if you have an outstanding balance. Member agrees to maintain membership for the minimum length of time (term) as stated on this con-
tract. Drafting memberships automatically renew and can be cancelled only after the minimum contractual term has passed by following the cancellation
policy in the following paragraph. Cancellation prior to the agreed upon term does not eliminate member’s obligation to continue making monthly payments
as stated in this agreement (see health, disability & death exceptions). Member will be responsible for all unpaid balances as well as court costs and legal fees
associated with recovering said balances. All prices are guaranteed for only the length of time stated in this agreement.
Buyer’s Representations: You represent that you have not defaulted on any other contractual obligation with us. If you have, we may apply all amount paid
on this contract to your past unpaid obligation before processing this contract.
Restriction on Cancellation: If you fail to use your membership and do not use our facilities, you are not relieved of your payment obligation, regardless of
circumstance, except as provided for in this contract.
CANCELLATION POLICY: Please note all draft memberships will continue on a month to month basis until cancelled by member with a 30 day
written notice. Member must send a written notice by certified (returned receipt) mail to the following address: AMERICAN PAYMENT SERVICES ,
P.O. BOX 130, MARBLE FALLS, TX, 78654. YOU MAY NOT CANCEL AT THE FACILITY. All cancels take effect 30 days from the postmark on
the certified letter. Your membership slide card must be returned with your cancellation.
IF THE FITNESS CENTER GOES OUT OF BUSINESS AND DOES NOT PROVIDE FACILITIES WITHIN 10 MILES OF THE FACILITY IN WHICH
YOU ARE ENROLLED OR IF THE FITNESS CENTER MOVES MORE THAN 10 MILES FROM THE FACILITY IN WHICH YOU ARE ENROLLED,
YOU MAY CANCEL THIS CONTRACT BY MAILING A NOTICE TO THE FITNESS CENTER STATING YOUR DESIRE TO CANCEL THIS CON-
TRACT, ACCOMPANIED BY PROOF OF PAYMENT ON THE CONTRACT. THE WRITTEN NOTICE MUST BE MAILED BY CERTIFIED MAIL
TO THE FOLLOWING ADDRESS: P.O. BOX 130, MARBLE FALLS, TX 78654

IF YOUR DOCTOR DETERMINES THAT YOU ARE ILL OR INJURED TO THE EXTENT THAT IN YOUR DOCTOR’S OPINION YOU ARE UN-
ABLE TO USE THE FACILITIES AFTER THE DATE THIS CONTRACT TAKES EFFECT, YOU MAY CANCEL THIS CONTRACT AND RECEIVE
A PARTIAL REFUND OF YOUR UNUSED MEMBERSHIP FEE BY MAILING A NOTICE TO THE FITNESS CENTER STATING YOUR DESIRE TO
CANCEL THIS CONTRACT. THE FITNESS CENTER MAY REQUIRE PROOF OF ILLNESS OR INJURY. THE WRITTEN NOTICE MUST BE
MAIL BY CERTIFIED RETURN RECEIPT MAIL TO THE FOLLOWING ADDRESS: P.O. BOX 130, M ARBLE FALLS, TX 78654.
Relocation: You may cancel a term contract if you relocate more than twenty-five (25) driving miles from the facility at which you enrolled
or from an affiliated facility. You must give a written notice of your intention to cancel, satisfactory evidence of relocation such as a utility
bill, a $25.00 cancellation fee and you must not carry a past due balance. This must be sent in by certified return receipt mail to the following
address: AMERICAN PAYMENT SERVICES , P. O. BOX 130, MARBLE FALLS, TX, 78654. YOU MAY NOT CANCEL AT THE
FACILITY.
Assignment of Contract: We reserve full authority to sell, assign or transfer our right to receive payment from you at our discretion. If for
any reason a member is unable to use their membership, the member may transfer the remaining time to another person for a $25.00 fee. WE
DO NOT GIVE REFUNDS.
Waiver and Release: Use of our facilities is at your own risk, and we shall not be liable for any injury or damages resulting from your use of
our services and facilities. If you are aware of any health problems, we urge you to see your doctor before using our facilities.
Complete Agreement and Severability: The terms on both sides of this contract constitute the full agreement between you and us, and no
oral promises are part of the agreement.
AMERICAN PAYMENT S ERVICES
Automatic Customer Payments, Bank Drafts, Credit Card Processing, & Collection
PO BOX 130, M ARBLE FALLS, TX 78654 TOLL FREE PHONE: 888-493-9777 FAX: 830-798-8610
 EVOLVE PERSONAL TRAINING
AUTOMATIC PAYMENT ACCOUNT INFORMATION

I understand and agree to use the account information below for my membership dues as
outlined on page 1 and 2 of my membership agreement with Evolve Personal Training.

Membership Contract #: _______

Print Members Name : _______
Member’s Signature: Date / /
**Signature of Authorized Account Holder (if not member:)

Please print Authorized Account Holder’s name:

⇒ BANK DRAFT (Attach voided check here):

Payee’s Name Ck No.
Address
Phone # DL #

_________________________________________________________ $
___________________________________________________________________

Your Bank Name ____________________________

Bank Routing & Account #

(***Do not use a deposit slip or a credit union savings account***

⇒ CREDIT CARD DRAFT (Attach voided credit card slip here):

XXXX XXXX XXXX XXXX
Mo/Yr thru Mo/Yr DATE SERVER/CASHIER

Payee’s Name AUTHORIZATION NO REFERENCE NO

Evolve Personal Training Imprinted

XXXXXXXXX
QTY. DESCRIPTION AMOUNT

TAX
P URCHASER SIGN HERE SALES
X
Cardholder acknowledges receipt of goods and/or services in the amount
SLIP
of the Total shown hereon and agrees to perform the obligations set forth TOTAL
in the Cardholder’s agreement with the issuer.

(***All numbers including expiration date must be legible***)

This page is an addendum to your original membership contract with Evolve Personal Training.

AMERICAN PAYMENT S ERVICES

Automatic Customer Payments, Bank Drafts, Credit Card Processing, & Collection
PO BOX 130, M ARBLE FALLS, TX 78654 TOLL FREE PHONE: 888-493-9777 FAX: 830-798-8610
 5716 W. Hwy 290, #106
Austin, Texas 78735
512.358.8433
PERSONAL TRAINING STUDIO
SCREENING AND RELEAS ES
Evolve Personal Training is not a medical organization and its staff cannot provide medical advice. You are advised to consult with your physician prior
to beginning this exercise program and encouraged to seek periodic medical check-ups. If you are under the care of a physician, taking prescription
medication, or following a diet to treat an illness or disease, you should discuss this exercise program with your physician.

Medical Information (check any that apply) 1. What are your goals? (check all that apply)
Overweight Pregnant Lose inches Better fexibility
Shape and tone Be healthier
Poor posture Hypoglycemia
Better posture More energy
Arthritis/Bursitis Drug allergies Other (specify)
Bad back Hernia 2. What time will you most often work out?
Morning Afternoon Evening
Sports injury - Problem knees
3. Which days of the week will you most often work out?
Sleep problems Recent surgery Mon Tue Wed Thur Fri Sat
Fatigue/Drowsiness Asthma
Staff should know:
Nervous Tension Headaches
Physical activity Lightheadedness/Fainting

Major Coronary Risk Factors: (check any that apply)

Diagnosed with hypertension High cholesterol (>200mg/DL) Diabetes Mellitus Family history of coronary disease
Type I
Cigarette smoker Phlebitis Embolic Diabetes Mellitus Other heart conditions:
Type II

High Blood Pressure Do you take a Beta Blocker? Yes No Are you taking medication/supplements to help with weight loss? Yes No

Read and sign acknowledgement and agreement to the following:

The above screening has been reviewed prior to engaging in any physical activities.

I do hereby further declare myself to be physically sound and suffering from no condition, impairment, or other illness that would prevent my
participation or use of the facilities and equipment. I do further hereby acknowledge that I have been informed of the need for a Physicians
approval for my participation in exercise/fitness/weight loss activities, or use of equipment. I acknowledge that I have either had a physical
examination and have been given my Physician’s permission to participate, OR that I have decided to participate in activities, use equipment and
weight loss without the approval of a Physician and do hereby assume all responsibilities. .

I, the member or participant understand and agree that fitness activities including weight loss may be strenuous and/or hazardous activities and I
should contact a healthcare professional or doctor before beginning any new activities or weight loss program. I am voluntarily participating in
these activities and using Evolve Personal Training facilities and equipment with full knowledge of the dangers involved. I hereby agree to
expressly assume and accept any and all risks of injury or death related hereto.

In consideration of being allowed to participate in the activities and programs of Evolve Personal Training and use of its facilities and
equipment, in the addition of any payment of any fees or charges, I do hereby waive, release and forever discharge Evolve Personal Training , its
officers, agents, employees, representatives, executors, and all others from all responsibilities or liabilities for any injuries or damage resulting
from my membership or participation in any activities. I also hereby release all of the above and any others acting in their behalf from any
responsibility or liability for any injury of damage to myself or my belongings, including those caused by negligent act or omission, in
connection with participation/membership or use of equipment at Evolve Personal Training

INDEMNIFICATION: Member and all heirs, representatives or assigns hereby agree to indemnify, defend and hold harmless Evolve
Personal Trainingand its officers, employees, contractors, agents, successors or assigns from any and all claims for liability against without
limitation, including any interest, penalties, attorney fees and expense incurred either directly or indirectly by reason of, resulting from, or
associated with this Agreement and/or Evolve Personal Training .

MEMBER:
Printed Name Signature Date

PARENT OR GUARDIAN IF MEMBER IS UNDER AGE 18:

Printed Name Signature Date

EVOLVE PERSONAL TRAINING REP

Printed Name Signature Date