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Miner Pavilion Membership Registration Form

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    Please Select
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    • Afghanistan
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    MINER PAVILION MEMBERSHIP

     Walking, Run laps, Shooting baskets, etc.

     

    SINGLE PERSON                                    FAMILY

    $50.00 yearly                                        $100.00 yearly

                                                               (Two or more in household only)

     Key Card deposit: $10.00 (NO KEY CARD, NO REFUND)

    RULES:

    1.      MAKE SURE YOUR SHOES ARE CLEAN AND FREE OF ROCKS OR SAND

    2.      ONLY SERVICE ANIMALS ARE ALLOWED IN THE BUILDING (SEEING EYE DOGS)

    3.      NO SMOKING, ROLLER SKATES, ROLLER BLADES, SKATE BOARDS, BICYCLES, ETC. ANYWHERE IN THE BUILDING

    4.      IF THE PAVILION IS RENTED, KEY CARDS WILL NOT ALLOW ENTRY FOR THE DURATION OF THE RENTAL - IF THE DOORS ARE OPEN, PLEASE RESPECT THE PARTY AND DO NOT ENTER UNTIL THEY ARE NO LONGER USING IT

    5.      ANYONE ENTERING THE PAVILION MUST EITHER HAVE A PAVILION MEMBERSHIP OR PAY THE $2.00 DAILY USE FEE – PAYMENTS CAN BE LEFT IN WATER PAYMENT DROP BOX IN FRONT OF CITY HALL

    6.      IF YOU ARE THERE WITH A GROUP, PLEASE SEE THAT THE GROUP RESPECTS THE BUILDING AND DOES NOT ACT IN A WAY THAT MIGHT CAUSE HARM TO EACH OTHER UNNECESSARILY

    7.      CHILDREN UNDER THE AGE OF 18 MUST BE ACCOMPANIED BY AN ADULT AT ALL TIMES

    8.      NO HANGING ON THE BASKETBALL BACKBOARD RIMS – THEY ARE NOT BREAKAWAY RIMS

    9.      WHEN LEAVING THE BUILDING, MAKE SURE ALL DOORS ARE LOCKED, UNLESS OTHERS ARE STILL PRESENT-MAKE SURE ALL LIGHTS, WITH THE EXCEPTION OF THE AUTOMATIC LIGHTS, ARE TURNED OFF

    10.  LEAVE THE RESTROOM DOORS OPEN AND SHUT THE GYM DOORS TO THE LOBBY.

     

    Any one not adhering to the rules and regulations of the Miner Pavilion will have their membership privileges suspended or revoked.

     

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    CITY OF NEW MARKET – MINER PAVILION

    WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT

     

    1.             In consideration for participating in GYMNASIUM MEMBERSHIP(S), CLASSES AND/OR EVENT(S), I, ____________________ hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the City of New Market, IA,  their officers, servants, agents, and employees (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES, or otherwise, while participating in such activity, or while in, on or upon the premises where the activity is being conducted or in transportation to and from said premises.

    2.             To the best of my knowledge, I can fully participate in this activity.  I am fully aware of risks and hazards connected with the activity, including but not limited to the risks as noted herein, and I hereby elect to voluntarily participate in said activity, and to enter the above-named premises and engage in such activity knowing that the activity may be hazardous to me and my property.  I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or any loss or damage to property owned by me, as a result of being engaged in such an activity, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES or otherwise.

    3.             I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS THE RELEASEES from any loss, liability, damage or costs, including court costs and attorney’s fees, that may incur due to my participation in said activity, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES or otherwise.

    4.             It is my express intent that this Release and Hold Harmless Agreement shall bind the members of my family and spouse (if any), if I am alive, and my heirs, assigns and personal representative, if I am not alive, shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above named RELEASEES.  I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of Iowa.

    5.             I UNDERSTAND THAT THE CITY OF NEW MARKET WILL NOT BE RESPONSIBLE FOR ANY MEDICAL COSTS ASSOCIATED WITH AN INJURY I MAY SUSTAIN.

    6.             I further agree to become familiar with the rules and regulations of the NEW MARKET MINER PAVILION concerning adult/student conduct and not to violate said rules of any directive or instruction made by the person or persons in charge of said activity and that I will further assume the complete risk of any activity done in violation of any rule or directive or instruction.

    7.             I also understand that I should and am urged by City of New Market to obtain adequate health and accident insurance to cover any personal injury to myself which may be sustained during the activity or the transportation to and from said activity.

    8.             I ALSO UNDERSTAND THAT I AM RESPONSIBLE FOR ANY DAMAGE I CAUSE TO THE FACILITIES.

                    IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Waiver of Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Release for full, adequate and complete consideration fully intending to be bound by same.

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    Annual Membership Fee + One Time $10.00 Key Card Fee
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    Once you submit your application, we will contact you shortly to complete your membership application. 

    Thank you!

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