Kirtland AFB Fitness Center 24/7 Access User Agreement Active Duty/Guard/Reserve Last Name____________________ First Name ________________________ E-mail ______________________________ Unit/Squadron ______________________ Rank_________ Sex______ Phone Number __________________________
Retiree/Dependent (Dependent’s sponsor must also complete above section) Last Name _____________________ First Name _______________________ E-mail _________________________________ Sex___________ Phone Number__________________________ Initial Below: ______ I agree to abide by all Kirtland Fitness Center rules. I acknowledge that I am 18 years of age or older and I have a valid Common Access Card (CAC)/Proximity Card. ______ I understand that my Common Access Card/Proxy Card only grants ME access to the facility, and I will not allow any other individuals to enter the facility using my 24/7 access privileges. ______ I agree to leave the building at close of business and re-enter with my Common Access Card/Proxy Card once the fitness staff has cleared the building. This is a standard procedure to ensure that all personnel remaining after the COB transition have been accounted for. ______ I agree not to record audio or video of myself and/or others inside the Fitness Center. ______I agree to enter and exit through front entrance only. All other entrances are for emergency purposes. Opening these emergency doors to let unauthorized users in during after hours compromises the security of other patrons and the facility. Unauthorized use of these doors is strictly prohibited and could result in revocation of access privileges and will be reported to the member’s chain of command for potential disciplinary actions. ______ I understand where the emergency phones, emergency procedure instructions, the First Aid kit, and the AED are located inside the Fitness Center. ______ In the event of severe weather, I will proceed to the Shelter-in-Place location in Cardio Room 1 until the severe weather has passed. In the event of a power outage, I will gather my belongings and exit the building promptly. ______ I agree not to engage in any use of the Fitness Center that will result in self-injury or adversely affect my health or safety. ______I agree to observe good order and discipline while using the facilities. I will maintain a professional environment free from verbal or physical abuse, violence, intimidation, sexual harassment or assault and other disruptive behaviors. ______ I agree that in the event of a security threat, medical emergency or injury, I will dial 911 or seek appropriate emergency response. Local base contact information will be posted next to the phone near the front desk. ______ I assume all risk of injury and waive all rights to pursue monetary damages or any other relief of any kind as a result of injury or other loss occurring at or near Kirtland Fitness Center. In the event I am injured while at the Kirtland Fitness Center, I will hold harmless the United States Government, the United States Air Force and any administrative subdivision or agency thereof, and the respective personnel and employees thereof from all claims of any sort for damages or for other relief. ______ I understand the United States Government, United States Air Force, Kirtland Fitness Center, all administrative subdivisions and agencies thereof, and the respective personnel and employees thereof are not responsible for any of my personal property that is damaged, lost, or stolen while in or around the Kirtland AFB Fitness Centers.
Page - 1 - of 2