Summer Adult Strength & Conditioning

Transcription

1 Create Your Opportunity Summer Adult Strength & Conditioning [ Monday April 29th, Saturday November 2nd, 2019 ] Name: Home Phone Athlete Cell: Address: City: Country: Prov: Postal: Date of Birth (dd-mm-yy): Height: Weight: Comments/Injuries: How did you hear about Prime TRAIN TO MOVE : Select Your Program The Adult Train to Move program is an introductory - intermediate program aimed at correcting dysfunctional movement patterns, returning clients to the training environment, increasing healthy body composition, core strength, and cardiovascular endurance and capacity. Clients can expect a motivating and supportive environment with coaches that combine athletic experience and cutting-edge sports science protocols. Program runs: Monday April 29th, Saturday November 2nd, 2019 MORNINGS (AM) WEDNESDAYS 6:30-7:30 am THURSDAYS 6:30-7:30 am EVENINGS (PM) MONDAYS 6:00-7:15 pm WEDNESDAYS 6:00-7:15 pm FRIDAYS 6:30-7:45 pm

2 SATURDAYS 10-11:15 am TRAIN TO PERFORM : The Adult Train to Perform program focuses on improving strength and power with a large emphasis on power and Olympic lifting, anaerobic capacity, multi-directional movement, speed, and agility. Train to Perform program will include sprinting and other ballistic activities. Program runs: Monday April 29th, Saturday November 2nd, 2019 TUESDAYS 5:45-7 pm THURSDAYS 5:45-7 pm FRIDAYS 6:30-7:45 pm SATURDAYS 10-11:15 am MOVE/ PERFORM PROGRAM OPTIONS [ **PRICES INCLUDE GST** ] $ COST $ $ MONTHLY $ 10 CARD CLASS PASS (1 YEAR EXPIRY) $189-1x/ WEEK $80 2x/ WEEK $140 3x/ WEEK $170 4x/ WEEK $180 DROP- IN CLASS $21 - ** Please note Holidays that fall during our scheduled program; May 20th, July 1st, August 5th, September 2nd, October 14th. There will be no classes on these days and they have already been subtracted from the price. ** All programs are subject to GST and must be paid in full or a completed payment authorization form must be completed upon registration. Cancellation Policy: No refunds within 10 days to the start of your program. In the event of an accident or injury, athletes must provide a medical statement from their doctor and will be provided a credit minus a 10% administration fee. All cancellations outside of 10 days to the start of the program date will be provided a refund minus a 10% administration fee. PRIME SPORT PERFORMANCE RESERVES THE RIGHT TO CANCEL, RE-GROUP OR RESCHEDULE ATHLETES BASED ON ABILITY AND ENROLMENT. Due to the nature of group training, athletes will be

3 expected to make their scheduled training slots. Make up sessions will not be guaranteed.

4 Payment Information Cardholder Name Credit Card #: Exp. Date Visa MasterCard Amex Discover SIGNATURE DATE Billing Address (**If different than front page) City, Province, Postal: Phone#: PROGRAM PAYMENT OPTIONS **PRICES INCLUDE GST** $COST DROP- IN CLASS $21 10 CARD CLASS PASS $189 Please check mark ( ) box that applies Monthly Payments 1x/ WEEK 2x/ WEEK 3x/ WEEK 4x/ WEEK Please check mark ( ) box that applies: Payment #1- April 29th, 2019 $80 $140 $170 $180 Payment #2- June 1st, 2018 $80 $140 $170 $180 Payment #3- July 1st, 2019 $80 $140 $170 $180 Payment #4- August 1st, 2019 $80 $140 $170 $180 Payment #5- September 1st, 2019 $80 $140 $170 $180 Payment #6- October 1st, 2019 $80 $140 $170 $180 Total Amount $: [$480] [$840] [$1020] [$1080] I (full name) authorize Prime Sport Performance & Therapy to charge my credit card indicated below for $ on the of each month for payment of my bill, which has been provided to me by Prime Sport Performance & Therapy. SIGNATURE DATE I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify Prime Sport Performance & Therapy in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) I understand that Prime Sport Performance & Therapy may at its discretion attempt to process the charge again within 30 days, and agree to an additional $10 charge for each attempt returned NSF which will be initiated as a separate

5 transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of Canadian. law. I certify that I am an authorized user of this credit card/bank account and will not dispute these scheduled transactions with my bank or credit card company; so long as the transactions correspond to the terms indicated in this authorization form.