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Please use the link below to submit your membership payment. Select the appropriate membership price from the drop down menu. Membership payment MUST be completed before the Affiliate Membership form is submitted.
Date of Birth
Please review this diversity document
(See Photo Rules tab for photo requirements)
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I understand that as a guest of Elizabethtown College, I must abide by all policies, specifically to the Minors on Campus policy and the Sexual Harassment Policies including Sexual Misconduct, Sexual Exploitation, Stalking, Dating Violence and Domestic Violence. I have read and agree to this statement.
Memberships will not be prorated or refunded.
The Physical Activity Readiness Questionnaire for Everyone
The health benefits of regular physical activity are clear; more people should engage in physical activity every day of the week. Participating in physical activity is very safe for MOST people. This questionnaire will tell you whether it is necessary for you to seek further advice from your doctor OR qualified exercise professional before becoming more physically active.
1) Has your doctor ever said that you have a heart condition OR high blood pressure?
2) Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical activity?
3) Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? Please answer NO if your dizziness was associated with over-breathing (including during vigorous exercise).
4) Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?
5) Are you currently taking prescribed medications for a chronic medical condition
6) Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active? Please answer NO if you had a problem in the past, but it does not limit your current ability to be physically active.
7) Has your doctor ever said that you should only do medically supervised physical activity?
If you answered “YES” to one or more questions: A medical clearance form is required
• Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.• You may be able to do any activity you want — as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.• Find out which community programs are safe and helpful for you.
If you answered “NO” to all questions:
You can be reasonably sure that you can:• Start becoming much more physically active – begin slowly and build up gradually. This is the safest and easiest way to go• Take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively. It is also highly recommended that you have your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you start becoming much more physically active.• If you are not feeling well because of a temporary illness such as a cold or a fever – wait until you feel better; or• If you are or may be pregnant – talk to your doctor before you start becoming more active.
PLEASE NOTE: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.
Informed Use of the PAR-Q: Elizabethtown College assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity
I have read, understood to my full satisfaction and completed this questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that the community/fitness center may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.
Note: This physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if your condition changes so that you would answer YES to any of the seven questions.
I hereby acknowledge that my participation in Bowers Center for Sports, Fitness and Well-being Usage (the “Activity”), an activity/event, at Elizabethtown College (the “College”), during the Fall/Spring/Summer semester, is voluntary and that my participation in the Activity is a courtesy extended by the College.
RECOGNITION OF AND ASSUMPTION OF RISKS. I acknowledge that I am fully aware of and accept all risks, known and otherwise, related to the Activity, including but not limited to the risk of personal injury, up to and including death, all other risks to my health, safety, well-being, and property. I also acknowledge that participation in the Activity may exacerbate any medical condition, diagnosed or otherwise, that I have. Despite these risks, known and unknown, I choose to participate in the Activity. To the best of my knowledge, information and belief, I am able to fully participate in the Activity. I acknowledge that the College has recommended that I consult with a licensed physician, and follow that physician’s advice, before participating or continuing to participate in the Activity.
PROMISE TO BEHAVE RESPONSIBLY. In consideration of the permission granted to me by the College to participate in the Activity, I will conduct myself in a responsible, reasonable, manner at all times, including by complying with the Student Handbook at all times. Further, I understand that College may disallow me to participate in the Activity if my behavior does not comply with the standards of conduct required by the College. I agree that any money paid or costs incurred to participate in the Activity will be forfeited if the College disallows me to participate in the Activity.
INJURY OR ILLNESS. I understand that I am responsible for my health and promise not to participate in the Activity if I am injured or do not feel well. I also promise to seek immediate medical attention if, during the course of any activity related to the Activity, I become injured or feel unwell. I understand and agree that the College may not have medical personnel for each game, competition, or other event related to the Activity. I grant permission to the College to authorize emergency medical treatment, if needed, and in the event that I am unable to consent to such treatment. I agree that the College assumes no responsibility for any injury or illness resulting from any authorized medical treatment. I represent that I have health insurance and promise that if I become injured or ill as a result of my voluntary participation in the Activity, I will submit all medical bills and related costs to my health insurer.
RELEASE AND INDEMNIFICATION. For myself and any person who may claim through me or in my stead, and in exchange for and in consideration of the College allowing me to participate in the Activity, I assume all risks, known or otherwise, of injury associated with the Activity and any related activities. I agree to release, hold harmless, and indemnify the College, its Board of Trustees, officers, agents, administrators, employees, and independent contractors from any and all liability, actions, causes of action, claims or demands of any nature whatsoever, including without limitation negligence, that may result from my participation in the Activity, including travel or any other related activity.
By checking this box, I represent to the College that I have read and understood the above terms, have had ample time to consult with any legal advisors, and voluntarily agree with the above terms without condition and without duress.
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