GMHEC Edge Membership Enrollment Form
Please complete this form and submit your payment via the PayPal link on the GMHEC website to activate your membership to The Edge.  
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Email *
Name: *
College email address: *
Primary phone number: *
Date of birth: *
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Home address: (street, city, state, zip code) *
Emergency contact name and phone number: *
Has your doctor ever said you have heart trouble? *
Do you frequently have pains in your heart and/or chest? *
Do you often feel faint or have spells of severe dizziness? *
Has a doctor ever said your blood pressure was too high? *
Has your doctor ever told you that you have a bone or joint problem such as arthritis that has been aggravated or might be made worse with exercise? *
Is there a good physical reason not mentioned here why you should not follow an activity program even if you wanted to? *
Are you over age 65 and not accustomed to vigorous exercise? *
Membership type: *
Required
Release of Liability

In consideration of being allowed to participate in any way in the Sports & Fitness Edge, Inc. program, membership, relates events and activities, the
undersigned acknowledges, appreciates and agrees that:
1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and
while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,
2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases’ or others and
assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant
hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest employee or volunteer
immediately; and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next kin, hereby release and hold harmless Sports and Fitness
Edge Inc. d.b.a. The EDGE, their offices, employees, and other participants, sponsoring agencies, advertisers, and if applicable, owners and lessors of
premises used to conduct the event (“Releases”), with respect to all and any injury, disability, death, or loss or damage to person or property, whether
arising from the negligence of the release’s or otherwise, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND
THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Release of Liability signature (please type name in the space below) & date *
A copy of your responses will be emailed to the address you provided.
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