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Kosher Fitness Waiver
Please verify reCaptcha before submitting the form.
*
First Name
*
Last Name
*
Email Address
*
Mobile Phone Number
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Home Street Address
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*
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*
Zip Code
*
Date of Birth
*
Gender
Please select a gender
Male
Female
*
Synagogue Affiliation
Gym Cancelation
You can upload a maximum of 1 files.
For a limited time, you can get a 50% discount if you submit a cancelation of your current gym membership dated within the last 3 months through out your membership, until cancelation. *Approval Required.
*
Are you 18 years old or older?
Please select an option
Yes, I am 18 years old or older
No, I am 17 years old or younger
*If you are under 18 years of age. You will be required to be accompanied by a same-gender adult to enter the gym. (Father with his son or Mother with her daughter).
Please make sure to enter the below information for the same-gender adult that will accompany the minor and sign their waiver
We will also have limited supervised hours for any 15 to 17 year old child to work out if you are unable to come with your supervising adult
*
Parent or Legal Guardian First Name
*
Parent or Legal Guardian Last Name
*
Parent or Legal Guardian Email
*
Relationship to Minor
Please select an option
Father
Mother
Legal Guardian
*
Minor's School
*
Minor's Grade
Please select a grade
6th
7th
8th
9th
10th
11th
12th
*
Access Requirement for Minors
Access Requirement for Minors
I as the Parent or Legal Guardian understand that if I request Full Access for my minor I will have the credentials under my name as I am required to join and monitor my minor at the gym and if I requested Limited Access for my minor I will have to accompany my minor to the gym when the Rabbis buzz us into the gym.
If the minor will be joining the limited supervised hours as posted in the Minor's Whatsapp group that does not require the Parent or Legal Guardian to join, on behalf of my Minor:
I agree to listen to any instructions the supervisors give me.
I am aware that I can be suspended from gym usage if the supervisor(s) feel that I am not complying or doing something dangerous.
I understand that as a minor, I have access only during posted hours.
*
Hours and Access Terms
Hours and Access Terms
On behalf of my Minor:
I understand that I must comply with
these
exact times in order to maintain proper modesty standards to ensure that the Men and Women’s hours do not interfere with or overlap.
I understand that under no circumstances will I allow any other person to use my "key" without the express written permission of Torah Ohr.
If provided one, I agree to return my keycard to Torah Ohr when required.
I understand that Torah Ohr reserves the right to cancel and revoke my access if they feel a lack of responsibility on my part.
I understand that Torah Ohr is not responsible for lost or stolen items or anything left in the gym. After 30 days anything lost will be considered Hefker.
*
Liability Waiver
Liability Waiver
On behalf of my Minor:
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES being conducted by TORAH OHR HEBREW ACADEMY / Kosher Fitness Center (Torah Ohr) at 581-A Middle Neck Road, Great Neck NY 11023, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.
I CERTIFY that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional.
I CERTIFY that there are no health-related reasons or problems which preclude my participation in this activity.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate and that it will govern my actions and responsibilities at said activity. In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(1) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: Torah Ohr and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers;
(2) INDEMNIFY, HOLD HARMLESS AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge that Torah Ohr and their directors, officers, volunteers, representatives, and agents are NOT responsible for errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people, including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants but are also present for volunteers.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.
I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
*
Liability Waiver
Liability Waiver
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES being conducted by TORAH OHR HEBREW ACADEMY / Kosher Fitness Center (Torah Ohr) at 581-A Middle Neck Road, Great Neck NY 11023, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.
I CERTIFY that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional.
I CERTIFY that there are no health-related reasons or problems which preclude my participation in this activity.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate and that it will govern my actions and responsibilities at said activity. In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(1) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: Torah Ohr and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers;
(2) INDEMNIFY, HOLD HARMLESS AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge that Torah Ohr and their directors, officers, volunteers, representatives, and agents are NOT responsible for errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people, including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants but are also present for volunteers.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.
I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
*
Hours and Access Terms
Hours and Access Terms
I understand that I must comply with
these
exact times in order to maintain proper modesty standards to ensure that the Men and Women’s hours do not interfere with or overlap.
I understand that under no circumstances will I allow any other person to use my "key" without the express written permission of Torah Ohr.
If provided one, I agree to return my keycard to Torah Ohr when required.
I understand that Torah Ohr reserves the right to cancel and revoke my access if they feel a lack of responsibility on my part.
I understand that Torah Ohr is not responsible for lost or stolen items or anything left in the gym. After 30 days anything lost will be considered Hefker.
*
Membership Type
Please Choose One
Full Access via Mobile App - $10.50
Full Access via Keycard - $12.50
Limited Access - $0.00
Full Access:
Access to enter the gym via Mobile App or Keycard anytime during the
allotted hours.
Requires payment
Limited Access:
Access to the gym only via Torah Ohr Rabbis after learning at least 1 hour together
*Please note amounts are subject to change with 30-day notice
Additional Monthly Donation
Total Monthly Charge
All donations will go towards the improvement, management, and upkeep of the Fitness Center.
CANCELATION POLICY:
Cancelation needs to be requested 30 days before the next auto-payment is processed. Please Note that reactivating your account, should you want to sign up again, takes up to a week to process.
If a Keycard was requested, on cancelation it must be returned. Otherwise, there is a $5 one time fee.
Sat, April 19 2025 21 Nisan 5785