Please type in your email address

In consideration of Club Privata granting me a revocable membership , and participation in Club Privata events/activities  and use of Club facilities and equipment , I represent, understand and agree as follows: Member is purchasing a private Membership to the Club.  You as a Member understands and agrees that in addition to the purchase of the Membership, the use of Club Facilities and participation in club Activities requires additional fees (“Door Fees”) on a per-use basis.  Door Fees vary in price depending on Club Activities.   Additionally Door Fees may be increased or decreased at the discretion of the Club, which Member expressly acknowledges is within Club’s full discretion to establish from time to time

Purpose of Membership, Services, Activities, and Use of Facilities.  Member seeks to obtain Membership, participate in Activities, and utilize Facilities of the Club for the purpose of the following Member benefits(s); vigorous physical activities, education, community involvement, social activities, consumption of various healthy meals and food offerings, consumption of various alcoholic and non-alcoholic beverages, and other general social, physical, and mental health benefits.  Member acknowledges that the Member has received a written copy of the services provided by the Club. Transferability.  Member understands that Membership is non-transferable and may not be transferred, on a permanent or temporary basis, to another person.  Member may not loan, or otherwise allow the use of the Member’s Membership by another person, and any attempt to do so will result in the Member’s Membership being permanently revoked without refund of the Membership fee.  Additionally, Member understands that any Membership card, identification, or other item issued by the Club to the Member for the purpose of identifying the Member as a Member of the Club, is the sole property of the Club and must be surrendered to the Club upon demand by the Club. Sexually Explicit Environment.  Member understands that the Club is a sexually explicit environment and Member affirms that Member is not offended by nudity, sexual conduct, sexual images, sexual sounds, sexual conversations, or sexual acts that may be directly or indirectly sexually explicit in nature.  Furthermore, Member understands the Club is a social club that includes physical, mental, and other social benefits, and there is no direct or indirect promise, guarantee, or agreement that by virtue of paying Membership fees and/or Door Fees that Member is assured of sexual encounters.   Member certifies that Member will not engage in any act of prostitution or other illegal activities while in attendance of any Club event or while using the Club Facilities, and Member will immediately report any suspected illegal activities to Club staff

I Am At Least 21-Years of Age. The government identification I have presented is my valid identification legally obtained by me from the issuing agency using legal documents.  Furthermore, the name and signature I have presented on this Application reflect my legal name and signature. Inherent Risks and Dangers of Activities.  I understand and appreciate that known and unknown risks and dangers are inherent when engaged in nightclubbing and sexual activity including but not limited to; dancing activity, alcohol consumption, sexual activity, and other vigorous activities.  I understand that some Activities could result in property damage, contraction or transmission of sexually transmitted diseases, and personal injury, including death.   I agree and accept and assume all risks associated with the activity whether present or future, known or unknown, arising from or as a result of, my participation in the Club Activities or the use of the Club Facilities.  Understanding all of the risks involved, I hereby voluntarily elect to participate in Club Activities and use the Club Facilities.

Health Condition.  By signing this Application I agree a. My personal health is sufficient to safely engage in Club Activities, which may include but are not limited to activities that are physically demanding which may result in elevated heart rate, cardiovascular circulation, and increased breathing demands.  b. That I will bear all financial responsibility for any medical treatment arising from participation in Club Activities or the use of Club Facilities. • Club Privata Rules, Regulations, Dress Codes.   Member agrees to comply with the rules and regulations posted by the Club, explained to me by the Club staff, and provided to me in writing, as same may be amended from time to time relating to the use of the Club; including safety, acceptable clothing, hygiene and conduct.  Member acknowledges that the Club, at its sole discretion, may eject a Member for the Member’s failure to comply with the Rules and Regulations of the Club, additionally  the Club may elect to temporarily or permanently suspend or revoke the Member’s Membership with no refund.  Furthermore, the Club reserves the right to bring civil legal action against any Member who violates this section, or engages in any other actionable conduct. a. Member agrees to not disable, enable, change, adjust, relocate or otherwise alter; Club lighting, Club signage, Club doors, Club entrances, Club exits, Club traffic paths, Club fire sprinklers, Club fire extinguishers, Club safety equipment, Club fixtures, Club furniture, Club audio & visual equipment, or any other items indicated by a Club staff member. b. Member will not smoke in the club this includes all electronic cigarettes.    c. Member agrees not to disturb other members.  This includes but is not limited to: i. Opening of doors, drapes, or windows on rooms or areas where afore mentioned items are in a closed position. ii. Following/Stalking a member when the member has indicated verbally or through other commonly understood actions that they do not wish to have conversation or social interaction. iii. Treating a member with disrespect; such as aggressive or persistent attempts to engage the Member in conversation, social activities, sexual activities, rude or inappropriate comments or actions. iv. Touching any member without the member’s prior verbal consent. v. Any offer to engage in, any acceptance to engage in, or any engagement in any illegal activity including the possession of, use of, or offer to buy or sell any drug, or any act of prostitution will result in immediate and permanent termination of the offending member’s Membership. d. Member agrees to not engage in any careless or reckless behavior that may result in the injury, death, illness, or disease to the Member or another member. e. Member agrees not to bring into the Club weapons, knives, firearms, mace, stun guns, or other instruments that could be used to cause bodily harm to another person. f. Member agrees to not engage in any form of verbal confrontation, physical confrontation, or other activities that may result in arguments or physical conflict. g. Member agrees to wear clean clothes and maintain a socially acceptable level of personal hygiene while at the Club. h. Member agrees to comply with the Club dress code: i. All clothing, including shoes, must be clean and free of tears, stains, or offensive odors. ii. No baseball caps or other hats, other than those affiliated with a Member’s religion, may be worn while in the Club Privata . iii. No tee-shirts may be worn while in the Club. iv. Member agrees to not wear any other clothing determined to be offensive or inappropriate by Club management. i. Member agrees to not bring in Member’s own container(s) of alcohol. j. Member agrees to not over-consume alcohol while at the Club. k. Member agrees to obtain alcohol only from the Club’s licensed alcohol servers at the designated alcohol service locations, and only for the Member’s individual use, and not for delivery to or use by another Member.  Member further agrees to consume alcohol only in the area of Club facilities designated for alcohol consumption, and in no other portion of the Club facilities.  Member agreement not provide alcohol to, nor to obtain alcohol from another Club member, only from the Club’s licensed alcohol servers. l. Member agrees to not engage in any illegal activity while at the Club. m. Member agrees to report any suspicious or suspected illegal activity to Club staff. n. Member agrees to not remove any Club property from the Club. • Member agrees that at no time shall any still, video, or audio recording/transmitting be performed by or allowed by the Member while utilizing the Club Facilities or attending Club Activities. • Duty of Care. The Member agrees to exercise ordinary care while using the Club.  It is the Member’s responsibility to use the Club in a safe and reasonable manner and to observe the Rules and Regulations.  Member is also responsible for the conduct of the Member’s guests and Member is liable for all damages caused by the negligent or reckless use, or intentional misuse, of the Club by Member or Member’s guests.  The Member must immediately pay for any damage caused by the Member or Member’s guest to Club property, beyond that arising from normal wear and tear. • Sex Offender Disclosure By virtue of signing this Agreement the Member affirms that he/she has never been convicted of a sex crime including but not limited to; sexual assault, sexual battery, rape, sex abuse, molestation, sexual conduct with a child under the age of 18, sexual stalking, or any other sex related crime.  It is further understood by the Member that any future charge of a sex crime must be immediately disclosed to the Club management.  Furthermore, Member acknowledges the Club may use public information, such as Sex Offender Data Bases, to assist in validating the Member is not a sex offender

Damaged, Lost or Stolen Property. The Club is not liable for any damaged, lost or stolen property of the Member or Member’s guest. Members Right to Privacy. Member agrees to not disclose other member’s private information; including names, phone numbers, addresses, place of employment, etc.  The Club shall not disclose members’ private information unless so compelled by court order or in the normal course of a criminal investigation. Member’s Death or Disability. If Member dies or becomes disabled during the course of this Agreement the Club shall refund on a prorated basis the remaining value of the Member’s Agreement. Closure or Relocation of the Club. If the Club ceases operation or moves more than 5-miles from the current location of the Club, the Club shall refund on a prorated basis the remaining value of the Member’s Agreement, in an amount computed by dividing the contract price by the number of weeks in the contract term and multiplying the result by the number of weeks remaining in the contract term.  In the event the Club relocates and the Member desires a refund, the Member must submit a written and delivered request to the Club via mail to: Club Privata 824 SW 1st St Portland, OR, within 15-days of the Club’s relocation. Material Change of Club. If the Club materially and significantly changes the services offered by the Club, the Club shall refund, upon mailed and written request by the Member, on a prorated basis the remaining value of the Member’s Agreement, in an amount computed by dividing the contract price by the number of weeks in the contract term and multiplying the result by the number of weeks remaining in the contract term.  Member must submit a written and delivered request to the Club via mail to: Club Privata 824 SW 1st St Portland, OR, within 15-days of the Club’s changes of service.  The prorated refund amount will be calculated from the date of the post-mark on the mailed written request. Release and Indemnity Agreement. Using the Club Facilities and or participating in Club Activities involve the risk of injury, illness, or disease to Member or Member’s guest, whether you or someone else causes it.  Specific risks vary from one activity to another and the risks range from minor injuries, illness or disease to major injuries, illness or disease such as catastrophic injuries, illness, or disease that could result in death.  In consideration of Member’s participation in the Activities offered by the Club, Member understands and voluntarily accepts this risk and agrees that the Club and their respective officers, directors, employees, volunteers, agents and independent contractors will not be liable for any injury, including, without limitation, personal, bodily, or mental injury, economic loss or any damage to Member, Member’s spouse, Member’s guests, Member’s unborn child, or Member’s relatives resulting from any negligence of the Club or anyone on the Club’s behalf, or anyone using the Club Facilities whether related to Club Activities or not.  Member agrees to indemnify, defend and hold the Club harmless against any liability, damages, defense costs, including attorney fees, or from any other costs incurred in connection with claims for bodily injury, disease, illness, wrongful death or property damage caused by Member negligence or other wrongful acts or omissions.  Member further agree to hold harmless, defend and indemnify the Club from all liability, damages, defense costs, including attorneys fees, or from any other costs incurred in connection with claims for bodily injury, disease, illness, wrongful death or property damage brought by Member, Member’s guests, or Member’s family members, even if the Club was negligent.  Member understands and acknowledges that the Club is providing recreational and social services and may not be held liable for defective products nor the actions of other Club members.

BUYER’S RIGHT TO CANCEL If you wish to cancel this contract, without penalty, you may cancel it by delivering or mailing a written notice to the Club.  The notice must say that you do not wish to be bound by the contract and must be delivered or mailed before midnight of the third business day after you sign this contract.  The notice must be mailed to: Club Privata 824 SW 1st St Portland, OR.  If you cancel within the three days, the Club will return to you within 15 days all amounts you have paid. Important Information Regarding BUYER’S RIGHT TO CANCEL Member understands that Member’s use of the BUYER’S RIGHT TO CANCEL portion of this agreement does not release the Member from the Member’s Release and Indemnity Agreement nor any other portion of this Agreement as it pertains to injury, illness, disease or promise to hold harmless the Club, Club Staff, Club Members, Club Directors, or Club Agents.  Member’s use of the BUYER’S RIGHT TO CANCEL section of this agreement only releases the Member from the financial obligations of this Agreement and only results in the Member’s Membership being canceled and the Member’s Membership fee being refunded By signing below, Member acknowledges and agrees that Member has read the foregoing and knows of the nature of the Activities at the Club and agrees to all the terms of this entire Agreement.  Furthermore, Member understands that by signing this Agreement the Member is voluntarily and permanently waiving and/or limiting certain legal remedies as outlined in this Agreement

Club Privata is very passionate about what we do on a daily basis. We believe in open communication and you are encouraged to tell the world about our Club and share your passion. Guidelines for functioning in an electronic world are the same as the values, ethics and confidentiality polices employees are expected to live by every day, whether you’re tweeting, or posting on Facebook or Instagram. These new ways of communication are changing the way we talk to each other, and our members. In order to avoid any problems or misunderstanding, we have come up with a few guidelines to provide helpful and practical advice for you when you are posting on social media. You are personally responsible for the content you publish online. State that it is YOUR opinion. You are not an official spokesperson for Club Privata. Any comments you make regarding the club are your own. Remember the internet never forgets. Use common sense.  Protect yourself and our members. Be careful what personal information you share online and NEVER disclose personal information about our members or any Club Privata financial information of numbers. This includes all private club information. If it’s not already public information, it’s not your job to make it so. Act responsibly and ethically when participating in social media. Respect and honor our differences. Club Privata will not tolerate discrimination (including age, sex, race, color, creed, religion, ethnicity, sexual orientation, gender identity, national origin, citizenship, disability, or marital status or any other legally recognized protected class under federal, state, or local laws.)

Enter your full name as it appears on your I.D.