Membership Agreement Form

	Agreement Application Form
First Name		Last Name
Age		Sex	Male Female
Telephone		Email
Address

Employer
Address
Telephone		Occupation
Status		Birthday
In case of Emergency contact
		Telephone
Doctor		Today's Date
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Gymkhana urges all members to obtain a physical examination from their doctors prior to using any excercise equipment or attending any excercise classes. In recognition of the possible dangers connected with any physical activities, a member hereby knowingly and voluntarily waives any right of course of action of any kind whatsoever arising as a result of such activity from which any liability may or could accrue to Gymkhana, its officials, agents employees or instructors.

	I Accept *
	Form will not be processed without accepting the above terms and conditions . See also Membership and User agreement.