Agreement2 | Helton Silva BJJ

Membership Agreement

Student Information

Student 1 Name

Student 1 Birthday (MM/DD/YYYY)

Student 2 Name

Student 2 Birthday (MM/DD/YYYY)

Student 3 Name

Student 3 Birthday (MM/DD/YYYY)

Student 4 Name

Student 4 Birthday (MM/DD/YYYY)

Purchaser Information

Purchaser Name

Purchaser Birthday (MM/DD/YYYY)

Address

City

State

Zip

Preferred Contact Number

Subscription Details

Uniform Fee: $

Autopayment Of: $

on day

of each month.

Payment Today: $

* You are authorizing thes charges on your given card.

Agreement

Initials

This Membership is a dues membership. It begins on the signed date indicated below and continues for a minimum of 6 months. After this term the Contract becomes month to month with a 30 day notice for cancellation. Dues will be paid to Helton Silva Martial Arts on day undefined of the month. 30 days are required for cancellation of contract with no extra fees.

The member will pay a service charge of $35 for declined payments in addition to the uncollected funds.

Professors hold the right to promote, demote, or change class times based on age and ability. Students can be expelled from the program if they, or any family members of their family fail to follow rules or regulations of the Academy.

A Member's failure to make use of the facilities shall not relieve the Member of the financial obligations under the Agreement.

MEMBER UNDERSTANDS AND AGREES THAT ALL EXERCISES AND USE OF EQUIPMENT AND TRAINING PRACTICE ARE TAKEN AT SOLE RISK OF THE MEMBER/STUDENT AND THAT HELTON SILVA MARTIAL ARTS SHALL NOT BE LIABLE TO THE MEMBER/STUDENT FOR PERSONAL INJURIES CAUSED BY ANY CONDITION OF THE EQUIPMENT OR THE FACILITIES, STAFF, OTHER STUDENTS, OR BY HELTON SILVA MARTIAL ARTS NEGLIGENCE REGARDING SAME.

Member understands and agrees that Helton Silva Martial Arts shall not be responsible for any loss, theft, or damage to any personal property of the member wheter inside or outside of the Academy.

Authorization

Your Signature

I/We certify that we have received a completed and signed copy of the membership agreement and of any other document which I/We signed. This represents the entire agreement between Purchaser and Helton Silva Martial Arts. We further certify that I/We have read this agreement prior to affixing my/our signature and understand and agree to all the terms and conditions as stated.

By selecting the “I agree” button, I am signing this document electronically. I agree that my electronic signature is the legal equivalent of my manual/handwritten signature on this document. By selecting “I agree” using any device, means, or action, I consent to the legally binding terms and conditions of this document. I further agree that my signature on this document is as valid as if I signed the document in writing. I am also confirming that I am authorized to enter into this Agreement. If I am signing this document on behalf of a minor, I represent and warrant that I am the minor’s parent or legal guardian.

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