Search for:

Newsfeed
Contact Us
Join Online
Follow us on Facebook
Member Login
Rules and Guidelines

Home
About Us
Services
Classes & Programs
Membership Info

Home
About Us
Services
Classes & Programs
Membership Info

Dance Mix

03 Jun Dance Mix

Posted at 03:51h in by riithink

A high-energy dance class that uses low impact movements inspired by dance styles ranging from Latin, Jazz, to hip-hop.

100 CLYNELISH CLOSE
PITTSBORO, NC 27312
Phone:

Fax:

Join our Email List!

Hours

Monday-Thursday 6am-8pm.
Friday 6am-7pm.
Sat-Sun 8am-4pm.

About Us
Services
Classes & Programs
Membership Info
Class Schedules
CAREERS
CONTACT US
Terms and conditions
Rules and Guidelines
End user license agreement
Disclaimer Policy
No Surprises Act Policy
HIPAA Compliance Policy

© Developed by Duke Center for Living. All Right Reserved 2019.

View Privacy Policy

Membership Cancellation

"*" indicates required fields

PLEASE NOTE:

Requests must be received 30 days in advance of the requested start date and are subject to the Member Services Manager’s approval.

1. Complete Member Information.

Member(s) Name*

Todays Date*

MM slash DD slash YYYY

Cell #*

Email*

TERMINATION

30-Day Advance Notice

Other members on Agreement need to be re-written

Paperwork Attached

YES

NO

Locker Key Returned

YES

NO

File

Drop files here or

Max. file size: 50 MB.

May be granted immediately under the following circumstances and with proper written documentation. Members may not use services that are on the canceled account without incurring additional charges.

Relocation – Membership may be canceled with proof of address of relocation of 50 or more miles from the facility

Medical– Membership may be canceled with written documentation from a member’s physician stating that the member is directed to discontinue use of the facility and services.

Death – Memberships will be terminated upon notification of death, with written note from the estate executor

Consent*

I hereby agree that the above information is accurate and I authorize the Duke Center for Living and Galloway Ridge Inc. to amend my Membership Agreement and billing status accordingly.*

CAPTCHA

Phone

This field is for validation purposes and should be left unchanged.

Membership Vacation Freeze Request

"*" indicates required fields

PLEASE NOTE:

Requests must be received 30 days in advance of the requested start date and are subject to the Member Services Manager’s approval.

1. Complete Member Information.

Member(s) Name*

Todays Date*

MM slash DD slash YYYY

Cell #*

Email

VACATION FREEZE

Freeze may be granted for a minimum of one month and a maximum of 6 months, in full month increments only.
Freeze does not have to begin on the first of the month.
Cost of Freeze = $12 per month per member
Early return must have taken at least 30 days freeze
Members may not use services that are on a frozen account without incurring additional charges.

Start Date*

MM slash DD slash YYYY

End Date*

MM slash DD slash YYYY

Total # of Months:*

Total Cost: $__*

Reason

Consent*

I hereby agree that the above information is accurate and I authorize the Duke Center for Living and Galloway Ridge Inc. to amend my Membership Agreement and billing status accordingly.*

CAPTCHA

Membership Medical Freeze Request

"*" indicates required fields

PLEASE NOTE:

Requests must be received 30 days in advance of the requested start date and are subject to the Member Services Manager’s approval.

1. Complete Member Information.

Member(s) Name*

Todays Date*

MM slash DD slash YYYY

Cell #*

Email*

MEDICAL FREEZE

Physician’s Note must be received to implement the freeze clearly stating the reason for the request and must be faxed to DCFL at 919-545-2687 or emailed to: [email protected].
Freeze may be granted for a minimum of one month and a maximum of 6 months, in full monthly increments only.
Freeze does not have to begin on the first of the month.
There is no charge for the freeze. If a note is not received you will be charged $12 per month.
Freeze may be granted for a minimum of one month.

Start Date*

MM slash DD slash YYYY

End Date*

MM slash DD slash YYYY

Total # of Months:*

Total Cost: $__*

Reason

Physician Note Checkbox

Physician note is attached.

Physician will fax note to DCFL {919-545-2687).

Physician Note

Max. file size: 50 MB.

Consent*

I hereby agree that the above information is accurate and I authorize the Duke Center for Living and Galloway Ridge Inc. to amend my Membership Agreement and billing status accordingly.*

CAPTCHA

Medical Clearance/Pre-Exercise Questionnaire

"(Required)" indicates required fields

Name(Required)

Employee Initials(Required)

1. Do you have any of the following symptoms?(Required)

Chest discomfort with exertion

Unreasonable breathlessness

Dizziness, fainting, or blackouts

Ankle swelling

Unpleasant awareness of a forceful, rapid or irregular heart rate

Burning or cramping sensations in your legs when you walk short distances

None of the above

Provider Information (Only if answered yes to #1)

Name(Required)

Location(Required)

Phone(Required)

7d. FAX(Required)

2. Do you participate in regular physical activity? (Planned, structured physical activity for at least 30 minutes at a moderate intensity on at least 3 days a week for the last 3 months).(Required)

Yes

No

3. Has a physician ever told you that you have (or had) any of the following diagnoses? Check all that apply:(Required)

Heart attack

Any heart surgery or catherization

Heart rhythm disturbance

Pacemaker/implantable cardiac

defibrillator

Angina (chest pain/discomfort)

Heart valve disease or murmur

Heart failure

Heart transplantation

Congenital heart disease

Stroke/Transient Ischemic Attack (TIA)

Peripheral Vascular Disease

Pulmonary Disease

Diabetes

Chronic Kidney Disease

Other (specify)

None of the above

Please provide specific details regarding the diagnosis, including when and where it occurred, as well as the type of diagnosis.(Required)

Provider Information (Only if answered yes to #3)

Name(Required)

Location

Phone(Required)

7d. FAX(Required)

CAPTCHA

Cookie Policy: We use cookies on this site to improve your experience as explained in our Cookie Policy. You can reject cookies by changing your browser settings.

Powered by GDPR Cookie Compliance

Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

Strictly Necessary Cookies

Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.

Enable or Disable Cookies

If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.