Membership Enrollment Agreement

Enrollment Agreement
First & Last
First & Last
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Address
Address
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The purchaser agrees to pay to Encinitas Karate Inc. or its assignees, a monthly payment of the selected program (Once a week or Monthly). The monthly payment will be Re-occuring on todays date. I authorize the down payment and first months payment accordingly.
I agree to the above Statement for the following program and their respective monthly rate:
Program
Credit Card (no amex)
Credit Card (no amex)
I acknowledge tuition payments are based on an annual tuition amount that is broken up into 12 equal monthly payments regardless of whether a month has 5 or 4 weeks. Encinitas Karate Inc. operates on a 12 month, 48 week billing system. Encinitas Karate cannot refund any dues paid by reason of my absence, holiday closures or withdrawal from the course. Month to Month: I hereby agree to purchase a month-to-month term contract membership. I understand that my membership is non-refundable and that Encinitas Karate cannot refund any dues paid by reason of my absence, holiday closures or withdrawal from the course. Buyer may cancel this agreement at any time with 30 days prior written notification. I acknowledge that absences of less than 1 month are not eligible for freezing or credits. A membership cannot be frozen without a freeze agreement form signed 30 days in advance.I acknowledge annually on January 1st membership will increase 3%.
I, the applicant/undersigned, do hereby agree to indemnify and hold harmless Encinitas Karate Inc., its instructors, officers, directors, volunteers, officials, staff and contractors from any and al liability, losses or damages whatsoever, including emotional distress, arising from participation in any of their classes, programs and events. In case of accident or other emergency, instructors, officers, directors, volunteers, officials and staff of Encinitas Karate, Inc. are hereby authorized to secure medical care deemed necessary as a result of accident or injury for the participant. I further agree to pay any and all costs incurred as a result of this treatment. The Student/Parent/Guardian hereby represents that he/she has no knowledge of a physical/mental condition, which would render him/her unable to participate in martial arts training activities. Student further represents and promises that in the event that he/she becomes physically or mentally unable to participate therein, he/she will immediately notify Encinitas Karate in writing. Student/Parent/Guardian understands that during the course of instruction, employees or the school and/or other students or authorized persons will be engaged in a course of conduct requiring physical contact and he/she gives full consent to such contact as required by the training. Student/Parent/Guardian recognizes that regular class attendance is important for student progress and understands that it is the student’s responsibility to attend classes. It is further understood that the student is obligated to make payments whether or not the student attends classes. Student/Parent/Guardian authorizes Encinitas Karate, Inc. permission to reproduce, publish, circulate, copyright or otherwise use any photographs and/or videotape of student taken at the studio or events anytime without compensation. Student/Parent/Guardian t recognizes that regular class attendance is important for student progress and understands that it is the student’s responsibility to attend classes. It is further understood that the student is obligated to make payments whether or not the student attends classes.
I understand that I have signed a month to month contract, which will be serviced by Encinitas Karate Inc. Encinitas Karate Inc. reserves the right to add the following fees should any of the following occur: re-clear customer check and/or EFT draft- $5, unpaid EFT- $15, declined credit card debit- $15, unpaid credit card charge $25, late fee, more than 10 days- $10. My failure to attend classes or complete the course in no way relives my obligation to pay this promissory note in full. Should I default, I agree to pay all costs of collection, including reasonable attorney fees, court costs and collection agency fees. Membership is based on a 48 week year and no refunds apply during studio closures due to vacations, national holidays, and natural disaster. I hereby recognize the strenuous nature of martial art training and inherent risks of injury, the purchaser/member agrees to hold harmless Encinitas Karate Inc. and its officers/employees, members, and guests from all liability or damages whatsoever arising from participation in this program.
Purchaser’s/ Guardian’s signature