FitRec Membership Request

FitRec Membership Request
Please read before completing form.

If you are a current student, you do not need to complete this form. Your membership will be activated when you begin matriculating on campus. All other membership information can be found on the FitRec website at https://www.belmont.edu/FitRec
Please select the membership you are applying for:*

AlumniAlumni FamilyStudent, Faculty, Staff Family (do not check if you are current student, faculty or staff member)Lifetime MembershipRecent Graduate MembershipOther
Name*

First NameLast Name
BU ID#*
Date of Birth*

MonthDayYear
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Please indicate the relationship the applicant has to the member?

SpouseDependent child between the ages of 16-18
If Alum, what year did you graduate?
If you are a recent graduate, please provide month and year of your graduation.
If Alum Family, what is name of the Alum you are related to?
What is your relation to the alum mentioned previously?
To be eligible for a family member membership, the applicant must be between the ages of 16-18. Please confirm the applicant fits this age range.

YesNo
What is the BU ID number of the family member that is employed by, or attends, Belmont?
To be eligible for the lifetime membership, you had to graduate from Belmont between the Fall of 2001 and Summer of 2003. Please list when you graduated.
In case of emergency, please contact*
The recent graduate membership has a specific expiration date regardless of when the membership is approved. That date will be sent to via email or can be checked by accessing the member profile on FitRec Connect or by asking the worker at the front desk. Please initial here acknowledging this information. *
For more information about membership eligibility and pricing, please click HERE.
In consideration of the above factors and in consideration of the privilege of participating in the Fitness and Recreation area of the Beaman Center activities, the undersigned participant acknowledges the existence of risks in connection with the facilities and/or equipment. In addition, participation releases Belmont University, its officers, trustees, employees, students, and agents from any liability for claims arising out of the use of exercise equipment, participation in supervised and unsupervised activities in the gym, and in other individual or group exercise activities, and accidents occurring in the locker rooms and shower facilities of the center. The participant recognizes that possible injuries which may arise out of participation in the center’s activities include, but are not limited to, potentially fatal injuries such as heart attacks, stroke, and heat stress, as well as other injuries such as back injuries, broken bones, torn ligaments, etc. The participant releases Belmont University from liability for such injuries regardless of whether his or her damage or loss is caused by any negligent act or failure to act of the university or otherwise. Belmont University reserves the right to restrict use of the Fitness and Recreation area of the Beaman Center in instances where the member has a history of health problems that would render the member unqualified to participate in certain aspects of the center’s programs and activities. All decisions concerning restricted use will be made by the University after consultation with the member’s physician. The participant further acknowledges the existence of any need for certain rules concerning the use of equipment, facilities, and other procedures related to the Fitness and Recreation area of the Beaman Center. Each participant agrees to abide by those rules and to make every individual effort to assure that the equipment and facilities are kept in safe and useable condition. Having read the preceding, the participant acknowledges an understanding of those risks set forward and knowingly agrees full responsibility for any exposure to such risks. I understand that this membership is non-refundable and non-transferable.*
Once you submit this form, a member of our staff will verify your status and get back in touch with you with next steps.
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FitRec Membership Request

Please read before completing form.