Membership Application

Thank you for your interest in joining the Club 1 Fitness family! Our goal is to help you live a healthy life, and to reach your fitness goals. We partner with many local employers to offer corporate discounts. If your employer offers this benefit, please sign up at work to take advantage of the discounted membership rates! If this is not available through your employer, please fill out the application below:
Membership Benefits at Club 1 Fitness:
Free Weights - Body Building
Orientation to Cardio and weight equipment
Group Fitness Classses - FREE for members
Strength Training
Access to Indoor Basketball Courts
Heated Swimming Pool
Theraputic Whirlpool
Eucalyptus Steam Room
Dry Sauna
Recreational Swimming
Lap Swimming
Water Aerobics
Kids Zone - FREE with Family Memberships
Discounts on Club Promotions & Events
What made you decide to join the Club 1 Family? *
Please select a membership category: * 🛈

Contact Information

How many dependent children do you have who will be utilizing your membership? * 🛈
Please provide information on each child who will be participating:
 Full NameRelationshipGenderBirthdate
Child #1
Child #2
Child #3
Child #4
Child #5
Child #6

Payment Information

We are excited to have you in the Club 1 Fitness family!
Your membership will begin within a few business days. Before we can finalize your membership, we will need you to stop by our gym (3806 Broadway in Great Bend, Kansas) to pick up key cards for each member 14 years of age and older utilizing your membership.
Memberships enrolled through our online application are charged monthly, either through a bank draft from your checking account or through a charge on your credit card on the 5th of each month.
There is a one-time initiation fee charged at the time of joining. Initiation fees are $55 for single and senior memberships, or $110 for family memberships.
Monthly Membership Cost:
One - Time Initiation Fee *
Total Due Today:
Is the billing name and address the same as the primary applicant's? *

Membership Agreement

l understand that there is a one-time initiation fee charged at the time of joining, and I agree to pay for this fee through the same method I have selected to pay for my monthly membership. *
l understand that the minimum monthly membership requirement is six (6) consecutive months. I understand that membership will be continuous even after the minimum requirement is met until I cancel my membership in writing. I am liable for all membership dues and bills incurred including those bills incurred by dependent family members listed on this membership before my cancellation is complete. *
All cancellations take effect 30 days after written notice of cancellation has been provided. *
I understand that if I choose to cancel my membership before the six (6) consecutive months, I will be subject to a cancellation fee of $100. *
I understand that if my credit card on file is expired or declined, or if my checking withdrawal is declined, I will be subjected to a fee of $30. *
I agree to, and assume the full risk of injuries, including death and of all costs. I hereby agree and do waive, release, and relinquish all claims of every kind, known and unknown, present and future, that I may have against Club 1 Fitness and their officers, agents, and employees, arising out of, connected with, or in any way related to the program or my participation therein. I hereby also agree to indemnify and hold harmless and defend Club 1 Fitness, their officers, agents, and employees from all claims of every kind, known, unknown, present and future that I may have arising out of concern. *
Primary Applicant's Signature *
Secondary Applicant's Signature *
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