Welcome to Corpus Christi Athletic Club! Let’s get started… "*" indicates required fields Name* First Last Email* Phone*Birthdate* MM slash DD slash YYYY Do you live in the area?* Yes No How did you hear about CCAC?* Referral Signage Event Social Website Employer Previous Member Interests* Strength Training Cardio Group Fitness Classes Kid's Activities Personal Training Pickleball Tennis Swim Have you visited us before or been a member?* Yes No Do you currently have a gym membership?* Yes No What would you say best describes your goal?* Weight Loss Lean Up Strength WAIVER & RELEASE OF LIABILITY AND AGREEMENT TO ARBITRATE CLAIMS Waiver Consent* In exchange for permission to enter and use the facilities of the Corpus Christi Athletic Club, I, the undersigned participant, hereby confirm that: (a) I am in a better position to know of my physical condition and limitations than the Corpus Christi Athletic Club (together with its owner, Corpus Christi Athletic Club, LLC, and its employees, agents, officers, directors, affiliates and representatives the “Club") and I am not relying upon the Club to inquire, investigate, test, or otherwise determine if my physical condition is such that my use of the Club's facilities will cause me harm, (b) I have had full opportunity to inspect the Club's facilities and I am not relying in any way upon any warranty or representation by the Club as to the design, suitability or condition of those facilities, (c) I recognize that although the Club may have temporary control or custody over some of my personal property, the Club and I agree that the Club will not be responsible for the loss or loss of use of any this property, (d) I fully understand that any manner of physical exercise, and particularly exercise involving the use of weights, machines or other exercise implements, carries some attendant degree of risk of physical injury or death and (e) it is my intent, by executing this waiver and release, to accept all risks of injury or loss relating to the foregoing matters in clauses (a) through (d) except as set forth below to the fullest extent permitted under Texas law. Waiver Consent - 2* Accordingly, I hereby expressly release and forever discharge the Club (including all persons or entities described in 1(a), above) from and against all claims, injuries, causes of action, costs, damages, losses, expenses, and liabilities of any kind (collectively, “Liabilities”) resulting from my use of the Club’s facilities or arising while I am on Club premises, specifically including Liabilities arising from matters described in paragraph 1, above, WHETHER OR NOT SUCH LIABILITIES ARE CAUSED BY THE SOLE NEGLIGENCE, CONTRIBUTORY NEGLIGENCE, OR CONCURRENT NEGLIGENCE OF THE CLUB, but except to the extent such Liabilities arise from the Club’s gross negligence or intentional or willful misconduct. Waiver Consent - 3* I and the Club each agree and acknowledge that the Club’s provision of its facilities, equipment and services necessarily relies on channels of interstate commerce and that any controversy or claim arising out of or relating to this agreement, including any claim involving Liabilities, shall be determined by final and binding arbitration administered by the American Arbitration Association under its Commercial Arbitration Rules and Mediation Procedures subject to, and in accordance with, the provisions of the United States Arbitration Act, which act the parties agree shall govern on any question relating to the agreements set forth in this paragraph. Waiver Consent - 4* This agreement is executed and delivered on my behalf, and on behalf of any of my minor children who may enter or use the club, as well as on behalf of my heirs, executors, legatees, administrators or assigns.