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Apex Parks, Recreation and Cultural Resources
Open Gym Registration Form
Applications are processed at the Apex Community Center
Mon-Fri 8:00am-9:00pm - Saturday 9:00am-6:00pm - Sunday 1:00pm-6:00pm
The Community Center is closed on Sundays during the months of June-August
www.apexnc.org/services/parks-recreation-cultural-resources/open-gym
Applicant Name ____________________________________
Or parent if parcipant is under the age of 18 years
Address____________________________________________
Primary Phone_______________________________________
Email Address _______________________________________
Emergency Contact___________________________________
Other than parent of minors
Date of Birth ________________________________________
City_______________State__________Zipcode____________
Addional Phone____________________________________
Addional Email _____________________________________
Phone _____________________________________________
For Sta Use:
R____ NR____ Sta:________
Receipt #: ____________________
Fees (for ten visits):
Resident Age 0-7 Free
Resident Age 8-17 $5
Resident Age 18-54 $10
Resident Age 55 & Over Free
Non-Resident Age 0-7 $5
Non-Resident Age 8-17 $20
Non-Resident Age 18-54 $30
Non-Resident Age 55& Over $20
Open Gym membership fees are based on Resident status which are dened as individuals that reside within the established corpo-
rate limits of the Town, as dened by the Planning Department. (see hp://les.www.apexnc.org/docs/plan/apexstreets.pdf)
Open gym memberships do not expire and are non transferable. Do not risk losing your membership by allowing others to use your
card.
Children age 9 and under MUST BE ACCOMPANIED BY AN ADULT (18 YEARS OF AGE OR OLDER) AT ALL TIMES.
Parcipants MUST CHECK IN AND SHOW THEIR MEMBERSHIP CARD EACH VISIT. Failure to present the open gym card 2 mes will
result in a $5 fee on the third visit - NO EXCEPTIONS!!!
Guests may visit open gym with members for a fee of $5. Members may check in only a maximum of three guests per visit.
Personal sports equipment is not allowed in the facility.
Appropriate athlec shoes and clothing must be worn at all mes.
Absolutely NO FOOD, GUM or DRINKS permied in gymnasiums.
Absolutely NO DUNKING or HANGING ON THE RIM. Repeat oenses could result in suspension or permanent loss of privileges.
Horseplay, ghng, oensive language, and/or destrucon of Town property are prohibited at all mes.
Disrupve behavior will not be tolerated. Parents/Guardians will be contacted if there are problems. Repeated instances of problem
behavior could result in the suspension or permanent loss of membership privileges.
Personal items brought into the facility may be stored in the restroom lockers BUT MUST NOT REMAIN OVERNIGHT. Any locks will be
cut from lockers at close of business day and items will be put in the lost and found collecon. Lost and found items are donated
aer a 30 day period of me.
The Town of Apex is not responsible for any lost or stolen property.
The Open Gym schedule is SUBJECT TO CHANGE WITHOUT NOTICE and changes month to month. Calendars are available in the
Community Center lobby or you may check online at www.apexnc.org.
The APR&CR reserves the right to photograph parcipants for publicity purposes.
Statement of Waiver: I, for myself or as a parent or guardian hereby assume all risk and hazard incidental to the conduct of this acvity. I release, absolve and indemnify the
Town of Apex, employees of the Town, volunteers, contractor and sponsors from all risk and hazard associated with this acvity. In the event of injury, do expressly waive
all claims to the Town of Apex. I understand no insurance coverage is provided by the Town of Apex or the Parks, Recreaon and Cultural Resources Department. I further
give permission for proper emergency care to be rendered to myself or child should I not be able to give such permission.
Applicant Signature ________________________________________________________________________ Date:__________________
(Parent or Guardian if under 18 years of Age)
NAME DATE OF BIRTH NAME DATE OF BIRTH
List Additional Applicants for Open Gym Passes within the same household