MEMBERSHIP
ADULT/ CHILD AGREEMENT
STUDENT INFORMATION
Name:
Date of Birth of Member:
Address:
BILLING INFORMATION
LATE PAYMENT FEES AND RETURNED CHECKS: A late fee of $20 will be applied for any payments that are more than five (5) days late. A charge of $25 will be made for any checks returned due to insufficient funds. It is your responsibility to inform Source Jiu Jitsu Club of any changes in your billing/payment information PRIOR to the date your membership fee is charged. If you don’t notify us and the payment is declined and not paid within the 5 day grace period, you will be charged a late fee automatically.
By signing this agreement, I authorize Source Jiu Jitsu Club to bill my credit card to collect my monthly membership fee as stated in this contract.
COOLING OFF PERIOD:
You, the student, may cancel this agreement at any time prior to the midnight of the fifth business day of the date of this agreement, excluding Sundays and holidays. To cancel this agreement, email or deliver a signed and dated notice, which states that you, the student, are canceling this agreement, or words of similar effect. The notice shall be sent to Source Jiu Jitsu Club at info@sourcejiujitsu.com
BILLING:
Membership Fee will be collected monthly starting on first installment date and will continue to be collected on the same day of the month, REGARDLESS OF THE USE OF YOUR MEMBERSHIP. There is a one time registration fee billed at the time of enrollment ($150.00 for children ages 4-15 and $200.00 for teens and adults age 16 and older with the exception of Paid in Full and Women's Program). Women Only Program has a 50.00 registration fee.
Standard Membership Jiu Jitsu & MMA rate billed monthly is 199.99. Public service and Military members recieve a discounted monthly rate of 185.00 per month. MMA-Only Program membership rate is 120.00 monthly. Women-Only program is 99.00 monthly. Paid in Full options include 1) 12 months paid in full for 1910.00 & 2) Eight week introductory course for 300.00, billed once.
MEMBERSHIP POLICIES:
1-YEAR COMMITMENT AND PAID IN FULL: If you choose the 1 year commitment, this membership will AUTOMATICALLY BECOME A MONTH TO MONTH after the one year period is over, unless Source Jiu Jitsu Club receives and acknowledges a written notice requesting to not continue the membership. At this stage a 30 days cancellation notice is REQUIRED.
SIX MONTH COMMITMENT: If you choose the 6 month commitment, you have the right to cancel your membership for any reason and any time, but you must provide a 30 day written notice by email to info@sourcejiujitsu.com
MONTH TO MONTH: If you choose the month to month commitment, you have the right to cancel your membership for any reason and any time, but you must provide a 30 days written notice by email to info@sourcejiujitsu.com
MEMBERSHIP CANCELATION:
Adults.)
You have the right to cancel your membership FOR ANY REASON WITH A FEE EQUAL TO THIRTY (30) DAYS OF YOUR TUITION and a 150.00 cancelation fee. Your cancellation request must be in the method of a written notice to info@sourcejiujitsu.com and acknowledged by Source Jiu Jitsu Club. Your membership cancellation will not be processed until cancellation fee amount is collected in full AND Source Jiu Jitsu Club has received and confirmed your written notice, unless these two items have been received your account will continue to be billed monthly.
Kids.)
You have the right to cancel your membership FOR ANY REASON WITH A FEE EQUAL TO THIRTY (30) DAYS OF YOUR TUITION and a 150.00 cancelation fee. Your cancellation request must be in the method of a written notice to info@sourcejiujitsu.com and acknowledged by Source Jiu Jitsu Club. Your membership cancellation will not be processed until cancellation fee amount is collected in full AND Source Jiu Jitsu Club has received and confirmed your written notice, unless these two items have been received your account will continue to be billed monthly.
Facilities:
Source Jiu Jitsu Club reserves the right to alter the days, hours of operation and classes if deemed necessary to better fit the student’s needs.
RELEASE & WAIVER OF LIABILITY & INDEMNITY AGREEMENT
Permission to use photography:
I grant to Source Jiu-Jitsu Club, its representatives and employees the right to take photographs of me and my property in connection with the above-identified membership. I authorize Source Jiu-Jitsu Club, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Source Jiu-Jitsu Club may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.
RELEASE FROM LIABILITY AND INDEMNIFICATION (READ BEFORE SIGNING)
As a member, guest or participant at Source Jiu Jitsu Club, I understand and recognize that Jiu Jitsu and other Martial Arts are physically demanding activities and sports that involves physical contact and risk of physical injury. You as a member, guest or participant hereby agree to assume the risk of injury in it regardless of the cause.
As a condition of your membership and or participation, you also must agree that in the event any claim for personal injury or property damage is prosecuted against Source Jiu Jitsu Club, its agents and employees, the member and or participant shall indemnify and hold harmless Source Jiu Jitsu Club, its agents and employees from any and all such claims and causes of action.
I, for myself, my heirs, successors, executors hereby KNOWINGLY AND INTENTIONALLY WAIVE AND RELEASE, INDEMNIFY AND HOLD HARMLESS Source Jit Jitsu Club its owners, agents and employees, from and against any and all claims, actions, causes of action, liabilities, suits, expenses (including reasonable attorney’s fees) and NEGLIGENCE of any kind or nature, whether foreseen or in the physical activities and self defense training, whether such damages, loss, injury, paralysis or death results from NEGLIGENCE of Source Jiu Jitsu Club, or its agents, employees, or from some other cause. I agree that neither I, nor anyone act on my behalf, will make a claim, sue or otherwise maintain legal action of any kind against Source Jiu Jitsu Club as a result of any injury, paralysis or death to me as a member, guest or participant.
ACKNOWLEDGEMENT OF AGREEMENT TERMS based on my specific membership stated below:
I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.
I hereby am purchasing a membership at Source Jiu Jitsu Club independently owned/ operated by Gracie Barra Parkland LLC. By signing this agreement I acknowledge receipt of a fully completed copy of this agreement executed by both Source Jiu Jitsu Club and myself and acknowledge and agree to the agreement terms.
STUDENT, PARENT OR CO-SIGNER (IF UNDER 18) SIGNATURE