2015 Thurston County PAL & Elite Boxing Academy Membership Agreement

Transcription

1 2015 Thurston County PAL & Elite Boxing Academy Membership Agreement This membership agreement speaks to all terms & conditions, in this document. Members agree to the number of months indicated, which are 6, or 12, months of boxing classes/lessens. Payment will be made by check, cash, or stop by any Washington State Employees Credit Union, to make payment/s under TCPAL c/o Lydell Spry. Every member must follow all rules, and attend as many classes as possible weekly. Moreover, members who plan to compete, or not; in local, state, regional, national & international competition. It s understood each member/parents is obligating themselves to make the agreed upon monthly payment, as indicated. Each member will bring all boxing equipment/study material each day. All rules will be followed. The Elite Boxing Academy is under the umbrella of the Pacific Northwest Armature Boxing Association. All members who plan to compete, or not will be registered with USA Boxing; no exceptions. This protects them from any accident, or injury in conjunction with training/studying, traveling, to and from competition, home, and or sparring. Member/s who are not currently registered with USA Boxing, waives any and all claims of injury to their person, or to their family member/s, against the USA Boxing, PNWABA, Director, of the TCPAL, its members, or coaches. Additionally, members understand, the cost for uniforms, equipment, tournament fees, & protective gear etc is not covered by their monthly payment. Note: Please read this agreement in its entirety. By signing this agreement; each student/member, and parent are indicating; they are not currently under doctor s care, and are not aware of any medical condition/s which would hinder them in anyway, from participating in any and all of the following; high impact, cardiovascular, boxing exercises, aerobic, anaerobic, polymeric, running, and weight lifting regiment. If so; the student/member/parent or guardian will notify the Staff, Coach/Program Manager, or Director immediately before participating in any, and all of the aforementioned exercises. Most importantly, all members must have a copy of their last physical in TCPAL s file within 30 days of signing up. Each student/member/parent, or guardian agrees to make their payment; on, or before the 1st of each month for the number of months indicated above, regardless if they attend daily, weekly, monthly classes or not. There is a ONE-TIME $75.00 sign-up fee; added to 1st payment. All students 8 to 17 years of age; the payment/dues, or/fee is $ per month and $ per month for members 18 years and over. Private/one on one class is separate from regular classes. Training commitment are the same as stated above, but the payment is $ per week. NO REFUNDS. If payment is late, there will be $5.00 added after the 1st day. $20.00 added after every two weeks; no exception. Our academy colors are RED, WHITE, BLUE, & BLACK, Note: Your last month is FREE if you sign up for (1year, & pay the first 3 months up front). / /. / /..

2 Date Participant/Member Date Parent/Legal Guardian Membership for children ages 5 to 7 years of age have a minimum of a (3) month commitment from start date. Members ages 8 years and over, is (6) months or, (12) months Date of expiration is 3, 6, or 12 months from start date:.... Any questions call the Director/ Level III Coach, Lydell ; or me at coachspry@tcpal.org Facebook Lydell Spry, website our gym address is: th Ave S.W., Suite 2-C, Tumwater, WA Navigator, Mentor, Coach, & Trainer, Lydell Spry Keep a copy of this from for your file Authorizing for Dues Direct Payment Account type: Account holder name: Expiration date: name of depository institution: account number: routing number: By singing below, I authorize Thurston County Police Athletic League, (TCPAL) to charge, or to initiate transfers from, the account designated above for the purpose of making the payments which I owe to tcpal each month until all of my obligations (other than the Balance Due and related fees, and related charges if any) are paid under this agreement, or until the applicable membership is terminated or cancelled, whichever occurs first. I understand that my obligations under this agreement include monthly dues, annual increases in monthly dues, prepaid dues, family dues, upgrade or additional dues, charges and any other unpaid fees or dues including fees for special training classes (one on one class). This authorization will remain in full force and effect during the term of this membership agreement until cancelled by tcpal, or until receives my written revocation at Thurston County Police Athletic League, th Ave, S.W. Suite 2-C Tumwater, WA I understand that I may stop any ACH Debit (checking, savings, and debit card) by notifying the financial institution name above at least 3 days before the scheduled date of transfer. I also understand that the charges and transfers authorized by my signature below are different from the transfers (if any) authorized by any other agreement with tcpal (including transfers in payment of the Balance Due), and that such charges and transfers are likely to occur on the dates designated above. Cancellation or revocation of the authorization, of stopping any payment hereunder, does not affect any other payments authorized on the date of the agreement or in the future.

3 I understand and acknowledge the amounts debited to my account may vary each month between the amount shown in the applicable box above, and three times that amount, due to a change in monthly dues, past unpaid, and other fees and charges. I understand that I have the right to receive notice in writing at least 10 days in advance of any ACH Debit (checking, saving, debit card) that will fall outside of this range. I confirm that I am authorized under the terms of the applicable agreement with my financial institution (the Bank Agreement ) to use the account I have designated for the purchase of goods and services from tcpal. I certify that all statements made in this payment authorization are true and correct to the best of my knowledge. I understand that any failure by the applicable financial institution to pay any charge in full does not release me from any liability for obligations owing to tcpal. I agree to comply with my Bank Agreement at all times that this authorization is in effect. authorized signature.. Date signed... Related Member(s) Keep a copy of this from for your file

4 MEMORANDUM FOR RECORD SUBJECT: Rules and Guidelines for the TCPAL Elite Boxing Academy 1. The following rules, and guidelines set for members of the TCEBA Head Coach & Staff. 2. Note: There will be no exceptions to rules & guidelines. All Boxers & participants will: a) Keep safety as the utmost importance, b) Be motivated. c) Be honest. d) Be responsible for your actions. e) Be a Team Player. f) Have long and short term; realistic goals in life and in the gym. g) Be at practice 10 minutes prior, and have all equipment and ready to go on times. h) Use the proper chain of command if necessary. Senior team leader/team Captain or appointed person. Director/Coach/Assistant Coaches i) The coaches are the only ones who will give pointer during sparring, unless other wise directed. Motivating one another during the round robins/bag drill is highly recommended. j) There will be monthly Coaches and Boxer meetings to discuss any matters or ideas you may have; good, or bad. k) When traveling on road trips, athletes will conduct his/her self in a responsible manner in every situation/at all times. l) When any of these rules and guidelines is violated, the director, coach, or adult appointed person in charge, will decide the next, or best course of corrective action. m) Every member must have a physical prior to starting training. A copy will be kept on file. n)absolutely No Profanity what so ever- at any time For any reason. o)training times are as follows: 9:00am to 10:30, 6:30pm to 8:00 & 8:00pm to 9:30. We will add earlier times as the program grows. NOTE: By signing this memorandum you (the member), agree to conduct and Govern yourself according to the rules, and guidelines aforementioned Print Name Date Participant s Signature

5 PERSONAL DATA LAST NAME: FIRST NAME: MI: TELEPHONE #: SSN: AGE: DOB: HT: WT: # Fight(s): PLACE OF BIRTH: City: State: HOMETOWN: City: State: Headgear size: Sweat suit: Shirt: Trunk: RESIDENCE: address: MILITARY DATA UNIT ADDRESS: UNIT TEL: ROOM #: FLOOR#: RANK: DOB: DUTY POSITION: MEDICAL DATA EMERGENCY CONTACT: TELEPHONE #: RELATIONSHIP: DATE OF LAST PHYSICAL: BLOODTYPE: DATE OF LAST AIDS TEST: ALLERGIES: Keep a copy of this form for your file