Vanderbilt Hall Athletic Facility Application
Membership Information 

Non-Paid Harvard Appointees and Faculty (use form below) 
Non-Paid Harvard Appointees and Faculty must have a valid Harvard Staff or Officer ID card. 
Membership Fees are $456 per fiscal year (July through June, prorated the first of each month) which must be paid in full. You may apply on-line for the Vanderbilt Hall Athletic Facility using the form below. All memberships are non-transferable and may only be canceled according to the terms of the contract. Details are found at the bottom of this form. 

Harvard Students 
The center is available as a complimentary privilege to all Harvard University students. Students must have a valid Harvard Student ID card 

Harvard Medical and Dental School Employees 
All Medical and Dental school employees, who are eligible to join Fitcorp, may join and have full access to the Vanderbilt Hall Athletic Facility. Call or visit Fitcorp for rates and eligibility information. Fitcorp is located on the second floor of the Longwood Galleria. You may reach Fitcorp by calling 738-9229. 

 
 
THIS IS AN APPLICATION ONLY.  Upon submission of this on-line application form, a computer generated copy of this form will be faxed (or mailed) to the fax number (or address) you provide. This form must be signed and returned to the Vanderbilt Business Office, along with payment in full, and a completed Health History Questionnaire form, in order for your membership to be confirmed. Memberships will be confirmed either by e-mail, telephone, fax or mail. You may not begin using the facility until you have received notice of confirmation. Please call (617) 432-1629 to check on the status of your request.
Home Address Information
 
First Name:
Last Name:
Middle Initial:
Street Address:
City:
State:
Zip Code:
Country:
E-mail:
Home Telephone:
Fax Number:
 

Harvard Affiliation Information
(Applicants must provide their Harvard affiliation information below in order to be considered for membership. Harvard Medical and Dental school employees may not use this application (see above).
Harvard ID Number (first 8 digits only):
Hospital or Harvard School:
Hospital or Harvard Department:
Hospital or School Building:
Hospital or School Room Number:
Hospital or School Street Address:
Work Telephone Number:
Job Title or Position:
Emergency Contact Name (one):
Emergency Contact Phone (one):
Emergency Contact Name (two):
Emergency Contact Phone (two):

SCROLL DOWN TO SUBMIT FORM
 
 

TERMS AND CONDITIONS OF MEMBERSHIP
I agree to follow the rules and regulations of the Fitcorp managed Vanderbilt Hall Athletic Facility, as are in effect from time to time. I understand that this membership is subject to approval by the Vanderbilt Hall management and that it is non-transferable. I have read and understand the terms and conditions of my membership contract, and I understand that this agreement is subject to the rights of cancellation printed below. I further understand that any exercise program I undertake may create physical stress resulting in harmful effects. I agree that it is solely my responsibility to consult with a physician prior to commencing any exercise program, to remain under medical supervision if that is indicated, to seek medical assistance in the event of any injury, and to inform Harvard of any adverse change in my medical condition. I recognize that the use of the exercise equipment and other facilities provided by Harvard carries some risk of accidental injury to myself and to others, and I agree that I will use such equipment and facilities with due care. I hereby state that I will release and hold harmless the President and Fellows of Harvard College/Harvard Medical School, its directors, officers, employees, and agents, from any and all liability for loss, injury or damage which has been or may hereafter be sustained by me as a result of, or directly or indirectly related to my entering upon the Athletic Facility for any activities related thereto.

CONSUMER'S RIGHT TO CANCELLATION

You may cancel this contract without any penalty or further obligation by causing a written notice of your cancellation to be delivered in person or postmarked by certified or registered United States Mail within three (3) business days of the date of this contract or the date of your receipt to the address specified on this contract.
ADDITIONAL RIGHTS TO CANCELLATION
You or your estate may also cancel this contract for any of the following reasons:
    • If upon a doctor's order, you cannot physically or medically receive the services because of significant physical or medical disability for a period in excess of three months; In the case of your death;
    • If the health club services to be provided under this contract are not available because the seller fails to open a planned health club or location, permanently discontinues operation of a health club or location, or substantially changes the operation of a health club or location;
    • If you move your residence or your place of employment more than twenty-five miles from any health club operated by the seller or a substantially similar health club which will accept the seller's obligation under the contract.
REGISTRATION:
Members must check in and present their membership card to the security officer. The security officer will slide the member's card through the card reader upon each visit to the center to determine validity. We will not be responsible for cards left at the facility.

GUESTS:
Members may bring a guest with them at any time but management reserves the right to limit or refuse guests at its discretion. All guests must submit a valid form of ID to the security officer and be accompanied by a member at all times. It is the member's responsibility to insure that guests are aware of, and follow the center's rules and regulations. CRIMSON CASH IS NOT VALID FOR GUEST PASSES. Guest passes must be purchased in advance at the Vanderbilt Hall Business Office Monday through Friday between 8:00 a.m. and 6:00 p.m. Your Harvard ID acts as a debit card to pay for your guest's visit. Up to $100 dollars worth of credit may be added to your ID card. All guests must submit a valid form of ID, be 18 years or older, and be accompanied by the member at all times. When a member brings a guest to the facility, the security officer will slide the member's card through the card reader and deduct $5 from the member's Guest Pass account. Unused guest pass credit may be carried over to the next fiscal year. Refunds for unused guest passes will be made only during the fiscal year in which they were purchased. A receipt must be provided for all refunds.
NO ONE UNDER THE AGE OF 18 WILL BE ADMITTED INTO THE FACILITY.


Vanderbilt Hall Business Office
107 Avenue Louis Pasteur
Boston MA 02115-5750
(617) 432-1630
 

Vanderbilt Home Page

Last Updated: October 18, 2006