Masumeen Community House Fitness Centre Membership Application Section A. Applicant DetailsName* First Last Gender*MaleFemaleEmail Address* Phone*Emergency Contact Name* First Last Emergency Contact Phone*Address* Street Address Address Line 2 City State/ProvinceAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Section B. Terms of AgreementTerms of Aggreement*– Fitness Centre membership will provide access to exercise equipment located at the Masumeen Community House, 7570 Kennedy Rd. S. Brampton, ON, L6W 0A1. – Fitness Centre will be accessible for males and females during their respective designated time slots, which will be communicated when access is granted. – If you select, the Annual Membership this agreement is based on a twelve-month contract. To suspend your membership, a cancellation fee will apply if suspension is prior to completion of the twelve month contract. Cancellation Fee is 3-months of your monthly membership rate. – Fitness Centre members will be provided with a unique access code to access the premises. Shared access with a non-member will result in forfeiture of membership effective immediately. – The Fitness Centre is unsupervised. While reasonable safety precautions have been taken in relation to the use of the Fitness Centre, applicants assume risk and responsibility for any loss or damage to property or death or personal injury arising from their use of the Fitness Centre. Neither ISIJ nor its staff shall be liable for any loss or damage to property or death or personal injury arising from their use of the Fitness Centre. If required, applicants will consult a physician prior to exercising. I agree to the terms.Section C. Membership Type and PaymentPlease select membership type from the list below. **”Member” refers to member with ISIJ of Toronto. ** “Student” refers to individuals under the age of 26 attending full time education. **”Seniors” refers to anyone age 65 years and above. Masumeen Fitness Centre Membership*MCH – Fitness Centre-Member $10/monthMCH – Fitness Centre-Member $100/yearMCH – Fitness Centre-Non-member $15/monthMCH – Fitness Centre-Non-member $150/yearMCH – Fitness Centre-Student/Senior $8/monthMCH – Fitness Centre-Student/Senior $80/yearTotal 0.00 Δ