Aspirus Community Fitness Center - School District of Rhinelander

The Aspirus Community Fitness Center and Heck Family Community Pool
Revised: September 16, 2012
General Public – Hours of Operation through 6/8/2013:
Aspirus Community Fitness Center
(715) 365-9720
Aspirus Community Fitness Center –
Monday through Friday 6:00 to 7:45 am
Monday through Thursday 3:00 to 9:00 pm
Friday 3:00 to 8:00 pm
Saturday 7:00 to 11:00 am
Sunday - Closed
Heck Family Community Pool – Effective October 7, 2012:
Open the first and third Sunday each month
For Members Only (see attached membership application) - 1:00 to 3:00 pm
Free to the Community - 3:00 to 5:00 pm
Children under the age of 12 must be accompanied and supervised at all times by a parent/guardian.
The Aspirus Community Fitness Center will be closed on the following dates:
September 1-3, 2012 (Labor Day) November 22-23, 2012 (Thanksgiving)
December 24-25, 2012 (Christmas) December 31, 2012 (New Year’s Eve)
January 1, 2013 (New Year’s Day) March 29, 2013 (Good Friday)
May 25-27, 2013 (Memorial Day) July 4, 2013
Public Rates (Membership Application Attached):
Individual - $15 per month for unlimited use the Aspirus Community Fitness Center and the Heck
Family Community Pool
Family - $25 per month for unlimited use the Aspirus Community Fitness Center and the Heck
Family Community Pool
Hodag Hall Walker – FREE
Student Rates:
Students between the ages of 12 and 18 years of age may use the Aspirus Community Fitness
Center and the Heck Family Community Pool free of charge. Students 12 and 13 years of age
must participate in an orientation.
While there is no membership fee, a completed membership application (waiver) is required.
School District of Rhinelander • 665 Coolidge Avenue – Suite B • Rhinelander, WI 54501 • (715) 365-9700

The Aspirus Community Fitness Center and Heck Family Community Pool
Revised: September 16, 2012
District Staff – Hours of Operation through 6/8/2013:
Aspirus Community Fitness Center
(715) 365-9720
Aspirus Community Fitness Center –
Monday through Friday 6:00 to 7:45 am
Monday through Thursday 3:00 to 9:00 pm
Friday 3:00 to 8:00 pm
Saturday 7:00 to 11:00 am
Sunday - Closed
Heck Family Community Pool – Effective October 7, 2012:
Open the first and third Sunday each month
For Members Only (see attached membership application) - 1:00 to 3:00 pm
Free to the Community - 3:00 to 5:00 pm
Children under the age of 12 must be accompanied and supervised at all times by a parent/guardian.
The Aspirus Community Fitness Center will be closed on the following dates:
September 1-3, 2012 (Labor Day) November 22-23, 2012 (Thanksgiving)
December 24-25, 2012 (Christmas) December 31, 2012 (New Year’s Eve)
January 1, 2013 (New Year’s Day) March 29, 2013 (Good Friday)
May 25-27, 2013 (Memorial Day) July 4, 2013
District Staff – Rates (Membership Application Attached):
Individual - $7.50 per month for unlimited use the Aspirus Community Fitness Center and the
Heck Family Community Pool
Family - $12.50 per month for unlimited use the Aspirus Community Fitness Center and the Heck
Family Community Pool
Hodag Hall Walker – FREE
School District of Rhinelander • 665 Coolidge Avenue – Suite B • Rhinelander, WI 54501 • (715) 365-9700

The Aspirus Community Fitness Center and Heck Family Community Pool
Revised: September 16, 2012
Policies for Use
Aspirus Community Fitness Center
(715) 365-9720
We strongly recommend and encourage everyone using equipment at the Aspirus Community Fitness Center receive a free
wellness orientation with a fitness coach prior to using any of the equipment.
1. Personal belongings, including gym bags, coats, purses, etc., are not allowed in the Aspirus Community Fitness Center.
Personal belongings should be kept in lockers. Please bring your own lock. The School District of Rhinelander and the
YMCA are not responsible for any lost or stolen items.
2. Please keep language appropriate for this family fitness center.
3. No food is permitted in the Aspirus Community Fitness Center. Drinks must be kept in a resealable, non-glass container.
4. Cell phones may be used for music with use of headphones. Conversations must be held outside of the Aspirus
Community Fitness Center.
5. Please return weights, magazines, mats and other equipment to their designated location.
6. Please report any malfunctioning or broken equipment to a YMCA staff member immediately.
7. Members must be at least 12 years old to use the Aspirus Community Fitness Center.
8. When others are waiting to use the equipment, please keep your cardio workouts to less than 30 minutes.
9. Personal training of others is prohibited unless performed by YMCA staff.
10. Clothing must be appropriate for this family fitness center. No offensive images or writing are allowed on clothing. No
jeans, cut-offs, or excessive side-cut muscle shirts allowed. Midriffs or excessive backs showing are prohibited.
11. Shoes should be clean and appropriate for physical activity. No open-toed shoes.
12. An orientation is strongly recommended for everyone, and is mandatory for all youth and teens ages 12 to 13.
13. Wipe down equipment, including machines, benches and mats after each use. There are cleaning stations located
throughout the Aspirus Community Fitness Center.
14. Do not sit on equipment between sets. When not in use, equipment should be available for others to use.
15. Do not drop dumbbells or other free weight equipment, unless using proper release technique, in designated areas.
16. All weights must be re-racked after each use.
17. Collars must be used during all lifts using plate weight and bars.
18. Spotters are strongly recommended for all free weight exercises.
19. Children under the age of 12 must be accompanied and supervised at all times by a parent/guardian.
School District of Rhinelander • 665 Coolidge Avenue – Suite B • Rhinelander, WI 54501 • (715) 365-9700

ASPIRUS COMMUNITY FITNESS CENTER MEMBERSHIP APPLICATION
Personal Information
Last Name, First Name, MI Home Telephone # Work Telephone #
Address (Street & P.O. Box) City, State, ZIP E‐Mail Address
Place of Employment Male Female Birth date: Month/Day/Year
Emergency Contact (Name) Relationship Telephone #
The following information is confidential and is
for statistical purposes only
Family Information
Name (Last, First, MI)
Date of Birth
(xx/xx/xxx)
Annual Household Income (OPTIONAL)
Under $10,000 $10‐$19,999 $20‐$29,999
$30‐$39,999 $40‐$49,999 $50‐$74,999
$75,000‐$100,000 Over $100,000
Age Relationship
Ethnicity: (OPTIONAL)
African American
Asian Caucasian Hispanic
Native American Other
Student
(Circle One)
Do you exercise regularly at least twice a week? � Yes � No All members of family? �Yes �No
If yes, have you been exercising for at least 6 months? � Yes � No All members of family? �Yes �No
Responsibilities and Releases
Code of Conduct ‐ School District of Rhinelander prohibits inappropriate behavior and conduct. This includes, but is not
limited to, profanity or abusive language, inappropriate attire, smoking, use of alcohol or drugs, the removal of SDR
property and criminal conduct of any type. Privacy ‐ I understand that I will not take any type of photo, video, or
electronic data of members or class participants at any time. Conduct detrimental to the association and/or in disregard
of the member policies and practices may result in suspension and/or termination of membership privileges and
possibly litigation. _____Initial
*Anyone who appears on the Sex Offender Registry is not eligible for a membership. ______ Initial
Be advised that the District premises are under camera surveillance. _____Initial
SIGNATURE ______________________________________________________ DATE____________________________
PARENT SIGNATURE (If Applicant is under the age of 18) ____________________________________________________
M/F

AUTHORIZATION TO HONOR ACH DEBITS OR DRAFTS OR CREDIT CARDS
BY THE YMCA of the NORTHWOODS for MEMBERSHIP PAYMENTS
1. I, the undersigned, authorize the financial institution, designated hereon to pay the YMCA of the Northwoods and charge to the credit card or account(s) identified
on the attached deposit slip(s) or voided check(s) on a monthly basis. I understand that my credit card or account(s) identified will be debited on the 1st or 15th of the
month (depending on when sign‐up occurs) to pay my membership for the following month. I understand my membership via bank or credit card draft is a monthly
commitment and will automatically be withdrawn every month unless I notify the YMCA in writing 30 days prior to my draft date.
SIGNATURE ___________________________________________________________________________________________ DATE____________________________
2. In the event my bank/credit card company does not honor my membership draft, I understand that I am still responsible for that payment to the YMCA, on behalf
of the School District, and for any service fee imposed by my bank. If more than two bank draft/credit card transactions are returned on my account, I realize that my
bank draft privileges will be revoked and I am responsible for the remaining balance due on my membership payable by cash only. A $25.00 service fee will be
charged on any returned bank draft or credit card transaction. No program sign up will be allowed until payments are received. Initial ____________
3. TERMS‐Upon expiration of the initial term, this agreement shall automatically renew at the then current rates for successive one‐month terms until such time as
either party shall deliver thirty (30) days written notice of termination prior to the expiration date of the then current term. Initial ____________
4. I understand that all payments are non‐refundable. Initial ____________
ADULTS: Attach voided check here (Free to students 12 to 18 years of age)
FOR OFFICE USE ONLY
Membership Type: _______Youth _______Adult _______College _______Family _______Short‐term
Transactions: Join Date ________/________/________ Joiner’s Fee $________________
Payment Options: _______Annual Full Pay $________________ _______Continuous Bank Draft $________________
_______Payroll Deduct ________________________________ Staff Initials: _______
RELEASE OF LIABILITY FOR USE OF FACILITIES
(Do not sign without reading)
This “Release of Liability” is made and entered into by and between the School District of Rhinelander (“the School District of Rhinelander”), the YMCA of
the Northwoods (“the YMCA of the Northwoods”), and _________________________________________________________________ (print name), the
undersigned. The “ACTIVITY” that this “Release of Liability” applies to is the personal use by the undersigned of physical exercise equipment and facilities
and/or the swimming pool owned by the School District of Rhinelander.
I understand the nature of the ACTIVITY, and that the ACTIVITY involves risks of serious bodily injury, including permanent disability, paralysis and death,
which may be caused by the actions or inactions of the School District of Rhinelander and/or the YMCA of the Northwoods, their respective boards,
commissions, agencies, officers, employees, volunteers, representatives, faculty, or students (the “RELEASEES”), my own actions or inactions, or the actions
or inactions of other ACTIVITY participants.
I hereby release and discharge the School District of Rhinelander and the YMCA of the Northwoods, as well as their respective boards, commissions,
agencies, officers, employees, volunteers, representatives, faculty, or students (the “RELEASEES”) from all liability, claims, demands, losses, or damages that
I suffer while engaged in or as a result of the ACTIVITY which are caused in whole or in part by the negligence of the RELEASEES or otherwise, including
negligent rescue operations. This “Release of Liability” does not release or discharge any RELEASEE(S) from liability for its/their own intentional or reckless
acts.
I will indemnify and hold harmless the School District of Rhinelander and the YMCA of the Northwoods, as well as their respective boards, commissions,
agencies, officers, employees, volunteers, representatives, faculty, and students (the “RELEASEES”) from any loss, liability, damage or cost which any may
incur, if, despite this “Release of Liability,” I or anyone on my behalf makes a claim against any RELEASEE.
I have read this “Release of Liability,” understand these terms and understand that I have given up substantial rights by signing this “Release of Liability.” I
have signed this “Release of Liability” freely and without any inducement or assurance of any nature. No RELEASEE has told me anything that is inconsistent
with or contrary to the terms of this “Release of Liability.”
_______________________________________________________________________ ____________________________________________
Individual’s Signature Date
________________________________________________________________________ ____________________________________________
Parent’s Signature if Individual is Under the Age of 18 Print Individual’s Name