Name
*
First Name
Last Name
Email
*
Contact Phone Number
*
Date of birth
*
MM
DD
YYYY
NEC PHONE NUMBER
*
NEC RELATIONSHIP
*
WHY DO YOU WANT TO THE MILL METHOD?
*
What are your goals?
How did you hear about us?
*
Which services do you require?
*
On average, how much training do you currently do per week?
*
Do you have any of the following medical conditions?
*
WE RECOMMEND THAT ALL PROSPECTIVE MEMBERS UNDERTAKE A COMPLETE MEDICAL ASSESSMENT PRIOR TO COMMENCING TRAINING WITH US.
IF YOU TICKED 'OTHER' ABOVE, PLEASE SPECIFY.
ARE YOU CURRENTLY TAKING ANY MEDICATIONS?
*
YES
NO
IF 'YES', WHICH MEDICATION?
DO YOU HAVE ANY ALLERGIES?
*
YES
NO
UNSURE
IF 'YES', WHICH ALLERGY?
DO YOU SMOKE?
*
YES
NO
IF 'YES' HOW MANY CIGARETTES DO YOU SMOKE PER WEEK?
DO YOU DRINK ALCOHOLIC BEVERAGES?
*
YES
NO
IF 'YES', HOW MANY DRINKS PER WEEK ON AVERAGE?
IMPORTANT WAIVER, RELEASE AND INDEMNITY
*
I, AS NAMED ABOVE, MAKE THE FOLLOWING REPRESENTATIONS:: • I HAVE NO IMPAIRMENTS, ILLNESSES OR CONDITIONS THAT MIGHT ENDANGER ME OR OTHERS WHILST TRAINING AT THE MILL GYM. • I WILL DISCLOSE ANY IMPAIRMENTS, ILLNESSES OR CONDITIONS THAT MIGHT AFFECT MY ABILITY TO TRAIN AT THE MILL GYM TO A TRAINER BEFORE UNDERTAKING ANY TRAINING. • I UNDERSTAND THAT TRAINING AT THE MILL GYM IS EXTREMELY MENTALLY AND PHYSICALLY DEMANDING AND INVOLVES SIGNIFICANT RISKS OF INJURY TO ME AND TO THOSE TRAINING AROUND ME WHICH EXCEED THE RISKS COMMONLY ACCEPTED IN OTHER SPORTS AND PHYSICAL TRAINING ENVIRONMENTS. • I UNDERSTAND THAT ACCIDENTS AND INJURIES RESULTING FROM FALLS, DROPPED WEIGHTS OR EQUIPMENT OR FAILED EQUIPMENT OR OTHER CAUSES MAY HAPPEN WITHOUT FAULT OR NEGLIGENCE ON ANYONE’S PART AND THAT SERIOUS INJURY OR DEATH MAY RESULT. • I HAVE READ THIS FORM CAREFULLY AND UNDERSTAND THAT BY SELECTING 'I AGREE', I AM RELEASING VALUABLE LEGAL RIGHTS THAT I MIGHT OTHERWISE HAVE AND THAT I INDEMNIFY THE MILL GYM FROM THE CONSEQUENCES OF MY NEGLIGENT OR INTENTIONAL ACTS THAT CAUSE DAMAGE OR INJURY. • I WILLINGLY ASSUME FULL RESPONSIBILITY FOR THE RISKS TO WHICH I WILL BE EXPOSED IN TRAINING AT THE MILL GYM AND IN PARTICIPATING IN ACTIVITIES ORGANISED BY THE MILL GYM.
RELEASE: IN CONSIDERATION OF THE FOREGOING, I, FOR MYSELF, MY HEIRS, EXECUTORS, ADMINISTRATORS, PERSONAL REPRESENTATIVES, SUCCESSORS AND ASSIGNS, WAIVE AND RELEASE ANY AND ALL RIGHTS, CLAIMS AND CAUSES OF ACTION I HAVE OR MAY HAVE AGAINST THE MILL GYM OR ANYONE ASSOCIATED WITH THE MILL GYM PTY LTD AND ITS ASSOCIATES, ITS AGENTS, EMPLOYEES, OFFICERS, DIRECTORS, SUCCESSORS AND ASSIGNS THAT MAY ARISE AS A RESULT OF MY PARTICIPATION IN THE MILL GYM CLASSES OR EVENTS AND ANY PRE AND POST CLASS EVENTS ACTIVITIES. I ACKNOWLEDGE THAT IN PROVIDING THIS RELEASE I AM NOT RELYING ON ANY REPRESENTATIONS MADE BY OR ON BEHALF OF THE MILL GYM AND DO SO OF MY OWN FREE WILL. FURTHER, I GRANT FULL PERMISSION TO THE MILL GYM TO USE ANY PHOTOGRAPHS, MOTION PICTURES, RECORDINGS, OR ANY OTHER RECORD OF THESE CLASSES OR EVENTS FOR ANY LEGITIMATE PURPOSE INCLUDING COMMERCIAL ADVERTISING. IF I AM SIGNING ON BEHALF OF A MINOR CHILD, I ALSO GIVE FULL PERMISSION FOR ANY PERSON CONNECTED WITH THE MILL GYM TO ADMINISTER FIRST AID DEEMED NECESSARY, AND IN CASE OF SERIOUS ILLNESS OR INJURY, I GIVE PERMISSION TO CALL FOR MEDICAL AND OR SURGICAL CARE FOR THE CHILD AND TO TRANSPORT THE CHILD TO A MEDICAL FACILITY DEEMED NECESSARY FOR THE WELL-BEING OF THE CHILD.
INDEMNIFICATION: I RECOGNISE THAT THERE IS RISK INVOLVED IN THE TYPES OF ACTIVITIES OFFERED AT THE MILL GYM. I ACCEPT LIABILITY FOR ANY INJURY THAT I MAY CAUSE EITHER TO ME OR TO ANY OTHER PARTICIPANT DUE TO MY NEGLIGENCE, OR MY INTENTIONAL ACTS OR OMISSIONS. I AGREE TO INDEMNIFY AND HOLD HARMLESS THE MILL GYM PTY LTD, ITS PRINCIPALS, DIRECTORS, AGENTS, EMPLOYEES, AND VOLUNTEERS FROM LIABILITY FOR THE INJURY OR DEATH OF ANY PERSON(S) AND DAMAGE TO PROPERTY THAT MAY RESULT FROM MY NEGLIGENT OR INTENTIONAL ACT OR OMISSION WHILE TRAINING AT THE MILL GYM OR WHILST ENGAGING IN ACTIVITIES OFFERED BY THE MILL GYM PTY LTD. I HAVE READ AND UNDERSTOOD THE FOREGOING ACKNOWLEDGMENT OF RISK, RELEASE OF LIABILITY AND INDEMNITY PRIOR TO SIGNING IT AND THAT IT SHALL BE BINDING UPON MY HEIRS AND ASSIGNS.
BY CLICKING ON 'I AGREE' BELOW, I HAVE READ AND UNDERSTOOD THE FOREGOING WAIVER, RELEASE AND INDEMNITY AND I UNDERSTAND THAT BY CHECKING THIS BOX, IT OBLIGES ME TO INDEMNIFY THE PARTIES NAMED IN RESPECT OF LIABILITY FOR INJURY OR DEATH OF ANY PERSON AND DAMAGE TO PROPERTY CAUSED BY MY NEGLIGENT OR INTENTIONAL ACT OR OMISSION. I UNDERSTAND THAT BY CHECKING THIS BOX I AM WAIVING VALUABLE LEGAL RIGHTS.
Code-of-Conduct
*
THE FOLLOWING DESCRIBES THE MILL GYM ('THEMILL') CODE-OF-CONDUCT.
1. ETHICAL COMMITMENT
AS AN ATTENDEE, MEMBER OR VISITOR TO THEMILL I UNDERSTAND AND AGREE TO FOLLOW THE MILL CODE-OF-CONDUCT AND ETHOS.
2. MY APPROACH
AT ALL TIMES MY APPROACH IS TO BE SAFE, RESPECTFUL, DILIGENT AND PROFESSIONAL.
I WILL ENSURE THAT I COMMUNICATE WITH STAFF AND MY FELLOW MEMBERS TO ENSURE THAT ALL SAFETY AND SECURITY ISSUES ARE THOROUGHLY ADDRESSED.
3. THE MILL GYM ETHOS
THE MILL OPERATES ACCORDING TO ITS ETHOS OF:
• RELENTLESS PURSUIT OF EXCELLENCE
• SENSE OF FAMILY
• DISCIPLINE
• PRIMACY OF OPERATIONAL CAPABILITY
• HUMILITY
• SENSE OF HUMOUR
• LOYALTY
• MUTUAL RESPECT
4. MEMBERSHIPS
I UNDERSTAND THAT MEMBERSHIP IS SUBJECT TO ADHERENCE TO THE MILL GYM CODE-OF-CONDUCT
MEMBERSHIP IS GRANTED AT THE DISCRETION OF THEMILL DIRECTORS (THE 'DIRECTORS')
MEMBERSHIP MAY BE CANCELLED AT ANYTIME, AT THE DISCRETION OF THE DIRECTORS.
5. ATTENDANCE
• ALL ATTENDEES MUST UNDERGO INITIATION SESSIONS PRIOR TO ATTENDING TRAINING IN ORDER TO BECOME FAMILIARISED WITH THE FACILITY AND SAFETY AND TRAINING REQUIREMENTS
• UPON COMPLETION OF THE FINAL INITIATION SESSION, ALL ATTENDEES MUST ACKNOWLEDGE THE RECOMMENDATIONS MADE BY THEMILL TRAINERS
• ALL ATTENDEES MUST AGREE TO AND/OR SIGN THE FOLLOWING DOCUMENTATION PRIOR TO COMMENCING ANY ACTIVITIES WITH THEMILL:
I. CODE OF CONDUCT AND TRAINING/BEHAVIOUR POLICY
II. WAIVER OF LIABILITY
6. BOOKINGS AND CANCELLATIONS
• BOOKINGS TO USE THE FACILITY MUST BE MADE ONLINE 12-HOURS AHEAD OF THE BOOKING TIME. THIS APPLIES TO ALL CLASSES INCLUDING THE GAC, OPEN-GYM, BJJ AND ATTENDANCE (OWN TRAINING) ETC.
• IF YOU CANNOT ATTEND A GAC/OTHER CLASS/ATTENDANCE BOOKING YOU MUST CANCEL YOUR BOOKING ONLINE
• CANCELLATIONS OF PERSONAL TRAINING APPOINTMENTS MUST BE MADE 24-HOURS IN ADVANCE OR THE SESSION PAYMENT IS FORFEITED
7. CONDUCT WITHIN THE FACILITY
CLIENTS USING THEMILL FACILITIES HAVE THE FOLLOWING RESPONSIBILITIES:
• KEEP PERSONAL HYGIENE TO A HIGH STANDARD. DUE TO THE NATURE OF TRAINING, ALL CLIENTS MUST SHOWER, USE DEODORANT AND HAVE SUITABLE FOOTWEAR AND CLEAN TRAINING ATTIRE PRIOR TO THE COMMENCEMENT OF ANY SESSION
• BRING A TOWEL FOR USE DURING TRAINING TIMES
• BE COURTEOUS TO OTHER USERS BY CLEANING UP ANY MESS FROM YOUR TRAINING SESSION I.E., SAND BAG MESS/EXCESSIVE SWEAT ON EQUIPMENT/EXCESSIVE USE OF CHALK IN TRAINING AREAS
• TRAIN SAFELY, HOWEVER EXCESSIVE/UN-NECESSARY DROPPING OF WEIGHTS WILL NOT BE TOLERATED
• CHALK MUST ONLY BE USED IF THE TASK LEGITIMATELY REQUIRES IT
• RETURN ALL EQUIPMENT BACK TO ITS CORRECT PLACE ONCE FINISHED
• SOCIAL GATHERINGS MUST NOT BE CONDUCTED ON THE GYM FLOOR. ADEQUATE SPACE IS PROVIDED IN THE LOCKER ROOM AND OUTSIDE THE FACILITY
• ALL GUESTS OF MEMBERS INCLUDING FAMILY ARE PROHIBITED (UNLESS GIVEN EXPRESS PERMISSION BY THE MILL)
• CHILDREN MUST NOT BE ON THE GYM FLOOR
8. ALL MEMBERS ARE RESPONSIBLE FOR THE MAINTENANCE OF THE FOLLOWING THEMILL GYM RULES:
1. NO SWEARING
2. NO SPECTATORS
3. ARRIVE WITH SUFFICIENT TIME TO WARM-UP
4. COUNT YOUR OWN REPS
5. NEVER FINISH ON A FAILED LIFT
6. BOOK IN ONLINE/CANCEL ONLINE
7. NO EXCESSIVE NOISE OR TALKING
8. RETURN EQUIPMENT TO ITS CORRECT PLACE
9. WARM UP AND RECOVERY ARE NOT OPTIONAL
10. CORRECT TECHNIQUE MUST BE USED AT ALL TIMES
11. DO NOT DROP OLYMPIC BARS OR NON-BUMPER PLATES
12. ONLY FULL ROM AND CORRECT TECHNIQUE WILL BE COUNTED
13. ARRIVE ON TIME TO CLASS WITH SUFFICIENT TIME FOR WARM-UP
14. IF YOU HAVE NOT COMPLETED INITIATION, THEN YOU CANNOT TRAIN HERE
15. IF YOU ARE ON THE GYM FLOOR THEN YOU MUST WORK. IF YOU ARE NOT WORKING, LEAVE
BY CHECKING THE 'I AGREE' BOX BELOW I AM STATING THAT I HAVE READ AND AGREE TO FOLLOW THEMILL GYM CODE-OF-CONDUCT. I UNDERSTAND THAT BY BREACHING THE CODE-OF-CONDUCT I MAY BE SUBJECT TO CANCELLATION OF MEMBERSHIP AT THE DISCRETION OF THEMILL MANAGEMENT TEAM.
