First Name
Last Name
Preferred Name / Display Name
Employee ID Number
Date of Birth
Gender Identification
Corporate Email
Work Phone / Extension
Personal Mobile Phone
Department / Division
Job Title / Role
Primary Work Location
HQ
Remote
Hybrid
Manager Name
Manager Email
Contact Full Name
Relationship to Employee
Primary Phone Number
Alternate Phone Number
Contact Email
Contact Full Name
Relationship to Employee
Primary Phone Number
Standard Employee (Complimentary): Full access to gym floor, group classes, and locker rooms during standard facility hours.
Extended Access Employee ($15/mo payroll deduction): 24/7 keycard access to off-peak automated zones and secure locker amenities.
Executive / Leadership Access Pass: Full facility access, priority class reservation, and executive locker assignment.
Contractor / On-Site Consultant ($30/mo payroll deduction): Day pass access during contract duration.
Security Badge Barcode ID* (Located on back of employee badge)
Locker Room Access Required
Executive Locker Room
Gender-Neutral Locker Room
Standard Locker Room
Day-Use Locker Assignment Requested?
Primary Facility Usage Days
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Primary Usage Windows
Early Morning (5:30 AM – 8:30 AM)
Mid-Day / Lunch Hour (11:30 AM – 2:00 PM)
Late Afternoon / Post-Shift (4:00 PM – 7:30 PM)
Off-Peak / Evening (7:30 PM – 10:00 PM)
Please read the following questions carefully. Answer YES or NO based on your current health status.
Screening Question | Yes/No | ||
|---|---|---|---|
1 | Has your doctor ever said that you have a heart condition OR high blood pressure? | ||
2 | Do you feel pain in your chest at rest, during daily activities, or when you engage in physical activity? | ||
3 | Do you lose your balance because of dizziness or have you lost consciousness in the past 12 months? | ||
4 | Have you ever been diagnosed with another chronic medical condition (e.g., diabetes, kidney disease, respiratory disease)? | ||
5 | Are you currently taking prescribed medications for a chronic medical condition or cardiovascular issue? | ||
6 | Do you currently have (or have had in the past 12 months) a bone, joint, or soft tissue problem that could be worsened by exercise? | ||
7 | Has your doctor ever told you that you should only perform medically supervised physical activity? | ||
8 | Are you currently pregnant or have you given birth within the past 6 months? |
Medical Conditions & Allergy Disclosure
List any chronic conditions or past injuries (e.g., ACL reconstruction, asthma, lower back herniation)
List any severe allergies (e.g., latex, cleaning agents, exercise-induced anaphylaxis)
Do you carry an EpiPen or emergency rescue inhaler?
Medical Clearance Notice: If you checked YES to any of questions 1–7 above, you must submit a signed Physician Medical Clearance Form before your facility keycard access will be activated.
Weight Loss / Body Fat Reduction | |
Muscle Mass Building / Strength Training | |
Cardiovascular Endurance / Heart Health | |
Stress Management & Mental Well-being | |
Posture, Flexibility & Injury Rehabilitation | |
Preparation for Athletic Event (e.g., Marathon, Triathlon, OCR) | |
General Movement & Energy Improvement |
How many days per week do you currently engage in moderate-to-vigorous exercise?
0 days (Sedentary)
1–2 days (Light)
3–4 days (Moderate)
5+ days (Advanced)
Which areas/services do you plan to utilize? (Check all that apply)
Free Weights & Power Racks
Resistance Machines & Cable Stations
Cardio Machines (Treadmills, Ellipticals, Rowers, Bikes)
Group Fitness Classes (Yoga, HIIT, Pilates, Spin, Boxing)
Wellness Suite (Infrared Sauna, Massage Chairs, Compression Boots)
Lap Pool & Hydrotherapy Zone
1-on-1 Personal Coaching & Nutrition Counseling
Option A (Recommended): I request a complimentary 30-minute 1-on-1 orientation with a certified fitness staff member to review safety procedures, emergency equipment, and proper machine setup.
Option B: I request enrollment in a small-group onboarding workshop (held Tuesdays at 12:00 PM and Thursdays at 5:00 PM).
Option C: I decline formal orientation. I certify that I am experienced in using commercial fitness equipment and assume all liability for improper equipment usage.
Please initial each line below to confirm understanding of facility safety protocols:
Initial | Acknowledgement | |
|---|---|---|
I know the locations of the Automated External Defibrillator (AED), First Aid Kit, and Emergency Stop Buttons on the main gym floor. | ||
I agree to use safety clips/collars on all barbell lifts and utilize a spotter when attempting heavy free-weight lifts. | ||
I agree to report any damaged, broken, or malfunctioning equipment to the front desk staff immediately. |
Please review and initial each requirement:
Requirement | Initial | |
|---|---|---|
Hygiene & Sanitation: All members must wipe down equipment before and after each use using provided disinfectant wipes. Gym towels are required on all bench surfaces. | ||
Attire Policy: Proper athletic apparel and closed-toe, non-marking athletic footwear must be worn at all times outside locker rooms. Shirts must remain on throughout the facility. | ||
Weight Floor Etiquette: Re-rack all dumbbells, weight plates, kettlebells, and accessories in their designated storage areas after use. Dropping weights or slamming weight stacks is strictly prohibited. | ||
Locker Policy: Lockers are for day-use only while on site. Contents left overnight will be removed and placed in Lost & Found at 10:00 PM daily. | ||
Guest Policy: Corporate Fitness Center access is strictly restricted to active employees with valid badges. Hosting non-employee guests, family members, or unauthorized contractors is prohibited without prior management approval. | ||
Media & Privacy: Photography, video recording, or cell phone camera usage is strictly prohibited in locker rooms, restrooms, and sauna areas. |
I acknowledge that my participation in activities at the Corporate Fitness Center involves inherent risks, including but not limited to physical injury, cardiovascular events, property damage, and severe disability. I voluntarily assume all risks associated with my use of the facility and equipment.
In consideration of being granted access to the Corporate Fitness Center, I hereby release, waive, discharge, and covenant not to sue the Company, its subsidiaries, affiliates, officers, directors, employees, and fitness center staff from any and all claims, liabilities, or demands arising out of my participation or use of the facility.
I confirm that all information provided in this form is true and accurate to the best of my knowledge.
Employee Consent:
Employee Signature
Form Template Insights
Please remove this form template insights section before publishing.
Below is an in-depth breakdown explaining why each section exists and what operational problems occur if they are removed.
Without strict identity verification, non-employees, unauthorized visitors, or former staff could enter the building's private facilities, leading to severe security breaches, overcrowding, and policy violations.
During a critical medical event (such as sudden cardiac arrest or a severe fall), on-site staff cannot lose precious minutes searching central company databases to figure out who to notify. Having immediate, verified contacts on the fitness center roster satisfies the employer's basic workplace duty of care.
Unmonitored facility access results in unpaid usage, keycard sharing among staff, unmanaged peak-hour crowding, and unbudgeted equipment wear-and-tear.
Allowing high-risk individuals to begin rigorous exercise without screening creates severe safety vulnerabilities on site. A medical emergency that could have been safely managed—or cleared by a doctor in advance—becomes an immediate crisis for on-site staff.
Without usage data, wellness budgets are spent blindly on programs or equipment employees don't want, resulting in low participation, wasted company funds, and poor overall return on health initiatives.
If an employee injures themselves on a complex machine due to misuse, lacking proof of an offered orientation makes it difficult to verify whether proper safety protocols were ever explained or provided.
Vague rules make operational enforcement nearly impossible. Without written rule acknowledgments, revoking access for disruptive, unhygienic, or unsafe behavior can lead to workplace disputes and friction with management.
Without a signed acknowledgment, the company lacks an official paper trail proving that the employee agreed to the facility's safety guidelines and health screening procedures before working out.
Mandatory Questions Recommendation
Please remove this mandatory questions recommendation section before publishing.
Here are the mandatory fields and questions from the Comprehensive Corporate Fitness & Wellness Center Onboarding Form template, along with the operational, legal, and safety reasons why they must be required.