THANK YOU FOR VISITING GENESIS HEALTH CLUBS.

I accept full responsibility for my use of any and all apparatus, appliances facility privilege or service whatsoever, owned and operated by this Club at my own risk and shall hold this Club, its shareholders, directors, officers, employees, representatives, and agents harmless from any and all loss, claim, injury, damage or liability sustained or incurred by me resulting therefrom. By completing this form you agree that we may communicate with you by phone, or by using electronic communications such as email and text messaging. Your information will not be sold by Genesis Health Clubs.

I agree to allow Genesis Health Clubs and its affiliates, agents, and service providers to contact me at the phone number listed using an automatic telephone dialing system, text message, artificial voice, or pre-recorded message to provide messages, including informational and telemarketing. I acknowledge that providing a phone number is not a condition of receiving any property, goods, or services. By providing a phone number, I certify that the phone number is accurate and that I own the rights to use that phone number and to give consent to call or text that number.