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, .. I ~ ~~!?L'!!E~~! Access Control Card I HERBY ACCEPT CARD # from PROVIDENT CENTRAL CREDIT UNION (Landlord) and agree to return it upon termination of employment. I further agree to assume the responsibility for safekeeping it. If this access card is lost or stolen, I will contact Provident immediately, and will assume responsibility for a $3.00 non-refundable replacement fee, even if the original card is returned. Date Company Name (typed) Signature For Office Use Only: Entered: Level: Fitness Center Guidelines And Waiver/Release From Liability In consideration of permitting employees of Provident Central Credit Union to use Provident Central Credit Union's Fitness Center and its equipment and facilities, I hereby agree as follows: I accept full responsibility for, and I accept all risks of, any and all physical, mental, or health injury or damage of whatever kind to me which might arise in any manner whatsoever, directly or indirectly, relating in any manner to my voluntary entry into the facility, or use of the equipment or facilities. I hereby release from, waive against, discharge, and hold harmless Provident Central Credit Union and its officers, each of them, with respect to any and all claims and liability, of whatever nature. with respect to any such health, physical, or mental injury or damage, however caused, and whenever occurring. I further agree to indemnify, protect, defend, and hold harmless Provident Central Credit Uhion and its officers each of them, with respect to any and all claims, liabilities, debts, demands. dues. causes of action, damages" and costs, including attorneys' fees might payor might incur as a result of any claim or demand of any kind made by me or by anyone acting through or on behalf of me, relating in any manner whatsoever to any such health, physical, or mental injury or damage'. I hereby acknowledge that I have read the contents of this document, and that I am familiar with and understand them. It is my intention that this document will 'be binding not only upon myself, but upon my heirs, administrators, executors, personal representatives, successors, assigns. and any other person or entity claiming by or through me.. Name (typed) Signature FAC-I 0 I (Revised 8/23/99) 'T T' I -..