Go Back Lorena Smalley August 1, 2024 Are you an existing member of the Westend Seniors Activity Centre? Renew your membership today by completing our online renewal form. Renewal Membership Form "*" indicates required fields WSAC Membership Renewal FormDate of Membership Renewal* MM slash DD slash YYYY Name* First Last Date of Birth* MM slash DD slash YYYY If your phone# has changed in the last year please updateHome Phone*Mobile PhoneEmail Address* Gender* Female Male If you have moved in the last year please update your addressAddress Street Address Address Suite# or Apartment # City State / Province / Region Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Emergency ContactThis section must be completed.Name* First Last Relationship*Home Phone*Do you have any medical conditions we should be aware of?If Yes, please provide details.Type your name as your signature*Date* MM slash DD slash YYYY Release & Waiver AgreementThis section must be completed.Release & Waiver Agreement*RELEASE AND WAIVER OF LIABILITY AGREEMENT ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT (HEREINAFTER “The Release Agreement”) BY SIGNING THIS YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE PLEASE READ CAREFULLY THE ACTIVITIES REFERRED TO IN THIS RELEASE AGREEMENT INVOLVE RISKS, DANGERS AND HAZARDS, INCLUDING RISK OF DAMAGE, LOSS, PERSONAL INJURY AND DEATH. THESE RISKS, DANGERS AND HAZARDS ARE MORE FULLY DESCRIBED ON THE FOLLOWING PAGES. ALL PARTICIPANTS IN THESE ACTIVITIES ARE REQUIRED TO SIGN THIS RELEASE AGREEMENT, WHICH IS INTENDED TO PREVENT PARTICIPANTS FROM SUING IN THE EVENT OF AN ACCIDENT. PLEASE TAKE THE TIME TO READ THIS DOCUMENT CAREFULLY. TO WESTEND SENIORS ACTIVITY CENTRE and THE MANUFACTURERS AND DISTRIBUTORS OF THE EQUIPMENT USED IN FITNESS PROGRAMS, and their respective directors, officers, agents, representatives, employees, volunteers, independent contractors, subcontractors, sponsors, successors and assigns (collectively the “RELEASEES”) DEFINITIONS The Westend Seniors Activity Centre shall be also referred to, from time to time as the “Operator.” In this agreement the term “Fitness Programs” shall include all activities, programs, events, classes and services provided, sponsored or organized by the Operator including but not limited to yoga, pilates, aerobics, dance, weight training, personal training and fitness conditioning equipment, machines and facilities; nutritional and dietary programs; orientation or instructional sessions or lessons, and all other such related activities. Other programs incorporated within the meaning of “Fitness Programs” include card playing, arts, crafts, music lessons and practice, walking, golfing and biking clubs and any and all programs that are put on by Westend Seniors Activity Centre. ASSUMPTION OF RISKS I am aware that my participation in programs involves risks, dangers and hazards, which could result in damage, loss or physical injury to me. Some of these risks, dangers and hazards include but are not limited to: Health – overexertion, dehydration, fatigue, lack of fitness or conditioning. Premises – defective, dangerous or unsafe condition of the facilities, falls, collisions with objects, equipment or persons. Use of Equipment – mechanical failure of equipment, negligent design or manufacture of equipment, the provision of or the failure by the Releasees to provide any warnings, directions, instructions or guidance as to the use of the equipment, or failure to use or operate the equipment within my own ability. Advice – negligent advice regarding Fitness Programs. My conduct and conduct of other persons, including NEGLIGENCE ON THE PART OF THE RELEASEES, may increase the risk of damage, loss, personal injury or death. I understand that Releasees may fail to safeguard or protect me from the risks, dangers and hazards of the fitness and recreational programs, some of which are referred above. Despite the risks, dangers and hazards of Fitness Programs, and fully understanding such risks, dangers and hazards, I wish to participate in the outlined programs with the Operator, and I FREELY ACCEPT AND FULLY ASSUME all such risks, dangers and hazards and the possibility of personal injury, death, property damage and loss resulting therefrom. In consideration of the Releasees allowing me to participate in Fitness Programs and permitting my use of their equipment, facilities and services, I hereby agree as follows: TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against THE RELEASEES AND TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury including death that I may suffer or that my next of kin may suffer as a result of my participation in Fitness Programs and any other recreational programs DUE TO ANY CAUSE WHATSOEVER including but not limited to: - negligence on the part of the Releasees - breach contract by the Releasees - breach warranty on the part of the Releasees in respect of the design, manufacture, selection, installation, maintenance of adjustment of equipment; - breach of any statutory or other duty of care including the duty of care owed under the Occupiers’ Liability Act, RSA 2000, c O-4, on the part of the Releasees; and - the failure on the part of the Releasees to safeguard or protect me from the risks, dangers and hazards of Fitness Programs, some of which are referred to in the Assumption of Risks sections of this agreement. 1. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any damage, loss, expense or injury to any third party resulting from my participation in Fitness Programs. 2. THIS AGREEMENT SHALL BE EFFECTIVE AND BINDING upon my heirs, next-of-kin, executors, administrators, assigns and representatives, in the event of my death or incapacity. SAFETY: I am familiar with the proper use of equipment. I am aware that there are fitness instructors and staff available to answer any questions I may have as to the proper use of the equipment. In entering into this Agreement I am not relying on any oral, visual or written representations or statements made by the Releasees with respect to the safety of Fitness Programs other than what is set forth in this agreement. INSURANCE: I am aware that the Releasees do not provide me with any disability, accident, liability or medical insurance or compensation should I become injured or cause personal injury or property damage to any third party while participating in Fitness Programs. JURISDICTION: This agreement and any rights, duties and obligations as between the parties to this Agreement shall be governed by and interpreted solely in accordance with the laws of the Province of Alberta. Any litigation involving the parties to the Agreement shall be brought solely within the Province of Alberta and shall be within the exclusive jurisdiction of the Court of the Province of Alberta. I understand that although the Westend Seniors Activity Centre endeavors to provide competent leadership and instruction for the club and or program I am joining, it cannot warrant in anyway, their competency or professionalism. I acknowledge that Westend Seniors Activity Centre organizes activities only and does not necessarily possess any special skill or knowledge in relation to any of the activities. I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT THAT I AM WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE, WHICH I, OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNEES, MAY HAVE AGAINST THE WESTEND SENIORS ACTIVITY CENTRE AND THE RELEASEES. I agree to the Release & Waiver Agreement.Code of ConductCode of Conduct*The Westend Seniors Activity Centre (WSAC) strives to provide a supportive environment wherein staff, volunteers, and Members are treated with respect and dignity. In accordance with WSAC’s work site health and safety management system and current legislation, all reasonable efforts will be made to ensure that employees, contractors, volunteers, and Members are not subjected to discrimination, harassment, or bullying as they work or participate in WSAC activities, and that appropriate action is taken when such behaviour is reported. CODE OF CONDUCT The Code of Conduct for Westend Seniors Activity Center (WSAC) outlines the behavioral expectations for members. Members are expected to: a. behave in a courteous and respectful manner toward others, b. be tolerant and patient with the limitations and weaknesses of others, c. be respectful of the individual and cultural differences of others, d. be considerate of the feelings of others, e. respect the personal belongings of others, f. act honestly and ethically in relationships with others, and g. promptly follow all safety instructions given by staff, instructors, or first responders. DISCRIMINATION, HARASSMENT, BULLYING, AND CODE OF CONDUCT VIOLATIONS a. The Executive Director will annually remind WSAC Members of the Code of Conduct. b. WSAC Members will abide by the Code of Conduct. c. When an instructor or a staff member believes it necessary to have a Member suspended for an incident related to discrimination, harassment, bullying, or a Code of Conduct violation, he or she will immediately refer the matter to the Executive Director. d. A Member who believes he or she has been subjected to discrimination, harassment, bullying, or a Code of Conduct violation, will make his or her objection clearly known to the offender and to the Executive Director. e. Complaints will be treated in confidence and the Executive Director will immediately conduct an investigation into the complaint. The involved Member or Members will be given an opportunity to explain. f. The Executive Director will initiate immediate and appropriate action in substantiated cases. When the Executive Director suspends a Member the consequences for the misbehavior must be reasonable, appropriate, enforceable, timely and corrective. The Member will be informed in writing regarding the terms of the suspension, the reason or reasons for the suspension, and the steps that can be taken to appeal it (if this is a suspension which can be appealed). g. In the event of discrimination, harassment, bullying, or a Code of Conduct violation involving the Executive Director, the President will be informed and will appoint an independent officer to investigate the matter. h. In the event of discrimination, harassment, bullying, or a Code of Conduct violation complaint involving the Board of Directors, the Executive Director will immediately appoint an independent officer to investigate the matter and recommend action. CEASING MEMBERSHIP/EXPULSION If after investigating the matter the Executive Director deems a complaint about a Member’s behaviour serious enough, the Board will schedule an expulsion hearing and invite the Member in question, the complainant or complainants, the Executive Director, and other parties that the Board considers advisable to attend. The Board will then conduct a hearing to determine whether or not expelling the Member is just and reasonable. A Member who has received an invitation to an expulsion hearing from the Board may not give written notice of the intent to end his or her membership without also giving the Board his or her written consent not to reapply for membership. A Member who has received an invitation to an expulsion hearing from the Board will not be deemed to have ended his or her membership through non-payment of membership fees, unless he or she gives the Board his or her written consent not to reapply for membership. The refusal of a Member, being considered for expulsion, to attend or participate in one or both of the following: - the Board expulsion hearing and/or - the debate of the expulsion motion at a Special General Meeting or an Annual General Meeting will not be sufficient reason not to proceed with the expulsion hearing or the vote for expulsion. If a Member is expelled and the individual’s membership fee for the year has already been paid in full, a full or partial refund may be paid to the former Member. APPEALS TO THE BOARD The purpose of the appeal process is to ensure that WSAC decisions and actions are made in a fair and responsible manner and in the best interests of the membership. It is expected that significant efforts will be made to resolve disputes and conflicts through conversation, discussion and problem solving. In instances where this is unsuccessful, the following matters may be appealable: 1. decisions of the Executive Director regarding major suspension, or 2. decisions or actions of the Board contrary to Board Policies. REQUIREMENTS FOR APPEALS TO THE BOARD 1. A request for an appeal to the Board will be made through the Executive Director. 2. A request for an appeal to the Board will be in writing, stating the basis for the appeal and will include a copy of the written decision(s) being appealed. 3. Directors of the Board who are in conflict of interest, or who believe that their judgment is unduly biased, will withdraw from the appeal process. 4. The Board will appoint an Appeal Committee made up of three Directors to hear the appeal. 5. A Board appeal hearing will be held and a written decision rendered, stating reasons for the decision, within 15 business days of receipt of the request for an appeal. 6. The appeal hearing will provide an opportunity for all parties to speak to the issues in dispute and to present pertinent documents. The appeal process is designed so that disputing parties will not require legal counsel. However, a person making an appeal may choose to be accompanied by a support person. If any party is to be represented by legal counsel, all parties must be notified in advance of the hearing. HEARING PROCESS Hearings will proceed in accordance with the following process: a. All parties are asked if they are prepared to proceed. If a party is not prepared to proceed the Chair will ask the party for reasons. The Chair will reschedule the hearing if he or she considers the reasons offered for postponement are sufficient. b. The Chair of the appeal hearing will introduce all parties and will state the purpose of the hearing, including a description of the decision under review. c. The Chair of the appeal hearing will provide an opportunity for each party to make a representation in support of that party’s position. d. The Chair of the appeal hearing will provide an opportunity for each party to respond to the representation or representations made by the other party or parties. e. The Chair of the appeal hearing will ask questions for clarification and will also invite the other hearing participants to ask questions. f. The Chair of the appeal hearing will adjourn the proceedings with thanks and will explain that the forthcoming decision of the Board will be final. In a closed session, the Appeal Committee will discuss the information provided and render a decision. The Chair of the hearing will inform all parties of their decision. I agree to the Code of Conduct.Type your name as your signature*Date* MM slash DD slash YYYY Witness types name here as a signature (optional)Date MM slash DD slash YYYY This field is hidden when viewing the formHow would you like to pay the membership renewal fee?* Pay it online Pay over the phone 2025 Membership Price: Total Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name 13687