* denotes required fields

NAME: *

DATE OF BIRTH:

ADDRESS: *

CITY: *

STATE: *

ZIP: *

PHONE: (PRIMARY) *

PHONE: (ALTERNATE)

EMAIL: *

 

COMPLETE THE SECTION BELOW FOR FAMILY MEMBERSHIPS ONLY
You MUST be at least 16 years old to use the Fitness Room
Please enter each family member’s name and date of birth who will be listed on your family pass

NAME 1:

DATE OF BIRTH:        

NAME 2:

DATE OF BIRTH:        

NAME 3:

DATE OF BIRTH:        

NAME 4:

DATE OF BIRTH:        

FITNESS ROOM MEMBERSHIP REGISTRATION FORM

PLEASE NOTE: YOU MUST BE AT LEAST 16 YEARS OLD TO ENTER IN THE FITNESS ROOM

Please complete the registration form below and press register.
 You will be taken to the payment option page.
Thank you!

Each membership plan includes keys. The keys are what will allow members into the fitness room. All entries are recorded by card and on camera. Giving a card to a non-paying member or obstruction of other rules will result in card suspension or lose of a membership.

Please use all fitness room equipment appropriate for your fitness capabilities. Be respectful of other members and the equipment.

Membership cards will only work if membership has been paid. You can prepay memberships or pay for a day pass.

No individual under the age of 16 is allowed in the fitness room at any time; even with supervision, this is prohibited!

By pressing the register button below to complete membership registration, you understand you are responsible for obeying the rules and consequences of using the fitness room. Russell Recreation is not liable for any accidents, injuries or any lost or stolen items.

VISITOR’S PASS $5.00
SINGLE MEMBERSHIP $25 per month or $275 per year
FAMILY MEMBERSHIP $35 per month or $385 per year

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701 Fairway Dr.,
PO Box 382
Russell, KS 67665

Phone: 785-483-6966
Cell: 785-483-7712

RUSSELL RECREATION COMMISSION

director@russellrec.com

 

Recreation ........... the benefits are endless!

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Russell Recreation Center

DIRECTOR
Mike Blanke

ASSISTANT DIRECTOR
Jerrie Parsons

COMMISSIONERS
Curtis Sohm
Dave Beagley
Cecilia Shumaker
Mike McKenna
Tammi Buhrle


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