MEMBERSHIP AGREEMENT

Transcription

1 MEMBERSHIP AGREEMENT This form must be completed by the student or parent/guardian if student is less than 18 years of age. The responsible party must read, agree to, and sign the agreement. A separate Liability Waiver Form for each individual student participating in the program must be signed before participating in an introduction or training classes. Student Name: Date: Parent/Guardian Name: Address: City: State: Zip: Cell Phone: Work Phone: Home Phone: How did you hear about us?: Emergency Contact: Emergency Contact Phone: STUDENT INFORMATION Please clearly print the name and birthdate of each individual student attending class. A separate Liability Waiver Form must also be completed by each individual participating in the program. Do any students have current or past injuries or illnesses that the instructors should be aware of? Kinetix Combat Sports & Fitness Page 1

2 MEMBERSHIP OPTIONS AND FEES Kids Brazilian Jiu-Jitsu: $59 per month Junior Muay Thai: $59 per month (ages 12-16) MMA Combo (BJJ and Muay Thai): $149 Family Pack A Rate: $149 includes 1 adult and 1 child Additional Children (add $45 per month for each): Adult Brazilian Jiu-Jitsu: $99 per month Muay Thai: $99 per month Women s Kickboxing: $60 per month Family Pack B Rate: $199 1 adult and 2 children The Registration Fee of $80 is due upon first month membership payment. Optional Fees Adult Uniform (Gi): $120 includes belt Kids Uniform: $100 includes belt AUTHORIZATION FOR AUTOMATED PAYMENTS Account Owner: Bank or Institution Name: Bank or Institution City, State: Payment Method: Credit Card Checking Account Savings Account Bank Routing Number: Bank Account/Credit Card Number: CC Exp Date: / CC Billing Zip Code: Payment Amount: ATTACH VOIDED CHECK By signing this form, you are agreeing to the terms noted within this membership agreement. Print Student Name (Parent/Guardian if under 18yrs of age) Signature of Student Date Kinetix Combat Sports & Fitness Page 2

3 RATES, PAYMENTS and REFUNDS MEMBERSHIP PERIOD A membership period is defined as one (1) month. Memberships are automatically renewed every month unless cancellation is provided at least thirty (30) days prior to your membership renewal period. Kinetix Combat Sports & Fitness reserves the right to change membership fee schedules at any time. MEMBERSHIP CANCELLATION If, for any reason, you need to stop training, either permanently or temporarily, you understand that it is your responsibility to provide written notice to Kinetix Combat Sports & Fitness at least 30 days prior to cancellation or suspension. MEMBERSHIP PRO-RATIONS Payments are processed at the beginning of the membership period. The first month of enrollment, which includes Registration Fee, will be pro-rated such that subsequent payments are due on the first (1 st ) day of the month. Payment for subsequent periods will extend your membership, and implies your continued consent to the terms of this agreement. Membership fees are non-refundable. Any tuition not received on time will be assessed a $15 penalty fee. Returned checks will be assessed a $25 penalty fee. I understand that it is my responsibility to make sure my payment is received on time. Should my credit card, bank account, or other form of payment change, I will notify Kinetix Combat Sports & Fitness at least 15 days prior to the next billing cycle to avoid any penalties. Kinetix Combat Sports & Fitness will not send a reminder of your payment being due. Your credit card or bank account statement will act as your receipt of payment. Kinetix Combat Sports & Fitness Page 3

4 FAMILY ADD-ON MEBERSHIPS Members with Family Add-on Memberships are entitled to a discount according to the Fee Schedule. Discounted rates are applicable so long as one family member is registered at the regular rate. The higher rate will apply to the regular Membership and the equal or lesser rate will apply to the Family Add-on Membership. If the regular membership is cancelled, the Add-on rate is adjusted to regular membership rates. RATE CHANGES Membership rates are subject to change. Rate Changes will be communicated in writing, and listed on the Kinetix Combat Sports & Fitness website located at kinetixcombat.com at least 45 days prior to implementation. The rate change becomes effective upon the member renewal date (next payment period) following the 45 day notification. BUYER S RIGHT TO CANCEL If you wish to cancel this agreement, you may do so by mailing a written notice by certified or registered mail to the address specified below. You may also send an to josh@kinetixcombat.com. The notice must say that you no longer wish to be bound by this agreement, and that you would like to cancel your membership. If any gear was provided, the BUYER will be responsible for the cost of the used gear. The notice must be delivered or mailed to: Kinetix Combat Sports & Fitness 226 E. Everett St. Falconer, NY You may cancel this agreement if you relocate your residence further than thirty (30) miles from any Kinetix Combat Sports & Fitness location. This agreement may also be cancelled if Kinetix Combat Sports & Fitness ceases operation. Kinetix Combat Sports & Fitness Page 4

5 CLASS SCHEDULE A regular class schedule will be posted at kinetixcombat.com. Kinetix Combat Sports & Fitness reserves the right to make temporary and permanent modifications to the schedule at any time, for any reason. ADDITIONAL COSTS Uniforms, equipment, seminars, camps, private lessons, etc. are all additional costs and are not included with tuition or registration. A uniform (Gi) is the only required equipment for Brazilian Jiu-Jitsu and may be purchased through Kinetix Combat Sports & Fitness, or any other supplier. Please ask your instructor for more information about Gi requirements. By choosing a membership plan and signing above, I indicate that I have read and understand the terms of this Membership Agreement, and that I have read and received a copy of the Liability Waiver Form. This agreement, and it s information, will remain on file, in a secure location, within the Kinetix Combat Sports & Fitness office unless the terms and conditions change. At that time, a new contract will be executed. Any and all credit card information will be destroyed after payment information is entered into our billing system. Kinetix Combat Sports & Fitness Page 5