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Wellness Center Re-Enrollment Form

Fields marked with * are required.
Resident Information
Resident Agreement
I understand that the Office of Graduate Medical Education will pay the $51.00 monthly enrollment fee for my participation in the MUSC Wellness Center. I also understand that under IRS Regulations, this is considered a non-cash taxable fringe benefit. As a result I will be taxed on the cash value of this benefit each payroll. All memberships will expire on June 30th of each year. In order to terminate this benefit prior to June 30th, I must complete the Wellness Center Termination Form supplied at the Wellness Center front desk.
Waiver of Liability
Member using the facilities and equipment does so at his/her own risk. Management shall not be liable for any damages arising from personal injuries or damages sustained by member on or about the premises of the center. Member assumes full responsibility for any injuries or damages and does hereby and forever release and discharge the center, owners, employees, and agents from any and all claims, demands, damages, right or causes of action, present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of member’s use or intended use of the facilities and equipment thereof.

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Contact Us

GME Office
169 Ashley Avenue
MSC333
Room 202 Main Hospital
Charleston, SC 29425
Phone: 843-792-2575
Fax: 843-792-9295

 

 
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