Renzo Gracie The Grove Membership Agreement
Agreement #{FriendlyId}
| Membership Details |
|
Member Info |
| Membership |
{membership_title} |
|
Name |
{name} |
| Start Date |
{start_date} |
|
Birth Date |
{dob} |
| End Date |
{expiration_date} |
|
Email Address |
{email} |
| Auto-renewing? |
Yes |
|
Phone |
{phone} |
|
Membership Recurring Cost
|
{membership_fees} |
|
Home Address |
{address} |
| One-Time Signup Fee |
{signup_fee} |
|
|
|
| DUE TODAY |
{membership_total_amount} |
|
|
|
|
|
|
Parent/Legal Guardian (If participant is a minor) |
|
|
|
Name |
|
|
|
|
Email Address |
{ParentEmail} |
|
|
|
Phone |
{phone} |
|
|
|
Home Address |
{address} |
|
|
|
|
|
|
|
|
|
|
| Payment Account Info |
|
|
|
| Credit Card |
|
|
Bank Account |
|
| Acct Owner |
{CreditCardAccountHolder} |
|
Acct Owner |
{EFTAccountHolder} |
| Last 4 Visible Digits |
{CreditCardNumber} |
|
Bank Acct Number |
{EFTAccountNumber} |
| Expiration Date |
{CreditCardExpiration} |
|
|
|
|
|
|
|
|
EFT Authorization:I, {name}, authorize Renzo Gracie The Grove, to transfer electronic funds on a recurring basis from the checking, savings, or credit card account I specified above for my membership dues. This authorization is to remain effective until Renzo Gracie The Grove has collected for all charges assessed in connection with the terms and conditions of this Agreement.
Membership Term: I acknowledge and agree that I will maintain membership and pay the dues specified above for a minimum Term of two {membership_duration}. I agree that I will be liable for dues for the entire {DurationCount} {DurationUnits} Term of this agreement in the amounts as stated herein regardless of usage or any change of circumstance.
- Down Payment: I am making an initial down payment of {DownPaymentAmount} as of {start_date}.
- Next Payment: I understand my next payment for
Membership Renewal: After the initial Term has expired, this Agreement shall automatically continue from month to month (or year to year for annual memberships) at the prevailing membership rate, which is subject to change, until I contact Renzo Gracie The Grove in writing to cancel. I am responsible for all charges billed or incurred prior to cancellation. I further agree that my membership benefits are exclusive to me and are in no way transferable to anyone else.
Renzo Gracie The Grove agrees to provide and the Student, {name}, agrees to purchase competent instruction, supervised by qualified personnel trained in the procedures and traditions of such activities.
The Student acknowledges and agrees as follows:
1. I have chosen to enter into the following program(s) and classes:
{ProgramList}
{ClassList}
2. Upon completion and full payment of any phase or program, students wishing to continue with the next phase or program must enter into a new Agreement.
3. {SchoolName} or any party designated by {SchoolName} may photograph or film me while I attend the premises of {SchoolName} and use of any and all such photos, video footage and/or video streaming for promotion, sales, publicity and advertising purposes for all media, including, but not limited to, the internet.
4. The required physical exertion may be strenuous and cause physical injury, and I am fully aware of the risks and hazards involved. I hereby represent that I am physically fit to receive and participate in the prescribed course of instruction. I acknowledge that I have been advised to consult with a physician prior to and regarding my participation in the Classes and that my physician has confirmed to me that I have no medical condition which would affect my full participation in the Classes.
5. In consideration of my being permitted to participate in the Classes, I for myself, my heirs, executors, administrators, successors, assigns and anyone else who may claim on my behalf hereby waive any and all claims, liability and damages I may now or in the future have against {SchoolName}, its directors, officers, instructors and staff and all persons acting under its authority and their respective heirs, executors, administrators, successors, and assigns, arising by any means whatsoever, including, but not limited to death, injury, damages to or loss to my person or property of any kind whatsoever, no matter how caused arising from or in connection with my participation in the Classes, however caused.
6. I further hereby release, remiss and forever discharge {SchoolName}, its directors, officers, instructors and staff and all persons acting under its authority and their respective heirs, executors, administrators, successors, and assigns from and against all demands, claims, actions, damages, costs and expenses arising from or with respect to death, injury, damages to or loss to my person or property of any kind whatsoever, no matter how caused, arising from or in connection with my participation in the Classes whether or not caused by, in whole or in part, the negligence or gross negligence of{SchoolName}.
7. I will hold harmless and indemnify {SchoolName}, its directors, officers, instructors and staff and all persons acting under its authority and their respective heirs, executors, administrators, successors, and assigns from any and all liability for any damage or injury to the property or persons of any third party resulting from my involvement in or presence during any of the Classes.
8. I will comply with all the rules and regulations of {SchoolName}.
9. I will pay a service charge of $20.00 for any payments 10 days past due. If there are three payments which are 10 days past due during the period of this Agreement, I agree to pay the remaining balance of the Agreement in full, in addition to any and all recovery charges incurred.
10. I hereby agree that if {SchoolName}, is unable to process my payment from the designated account provided by me {SchoolName} is permitted to use any of the other accounts information provided as many times and as often as needed to replace the unpaid payments and service charges as explained on section 9 of this agreement.
11. In addition to any rights and remedies it may otherwise have, {SchoolName} may terminate this Agreement upon ten days' written notice to me if I fail to comply with my obligations under this Agreement and do not cure any such failure within ten days after receiving notice of such failure.
12. Failure to attend the Classes does not relieve me of the obligation to pay the full tuition for the program or phase in which I am currently enrolled.
13. I understand that if the student and/or co-signer wish to cancel the Monthly Membership agreement on the stated terms set out, they may do so by sending a 60 day written notice, delivered to {SchoolName} at least 60 days prior to the cancellation date desired by the way of registered mail or in person to:
{SchoolName}
{SchoolAddress1}
{SchoolCity}, {SchoolState} {SchoolZipcode}
Annual Memberships and Punch Card Memberships cannot be canceled and are non-refundable.
14. An account will be considered in default status after 60 days. Facility access will be terminated by this date, if not before.
15. I confirm that the provisions in this Agreement constitute the entire agreement between the parties hereto and supersede all prior communications, proposals, representations and agreements, whether oral or written with respect to the subject matter of this Agreement.
16. {SchoolName} is committed to protecting the privacy of personal of our customers. We make every effort to ensure that the information you share with us is recorded accurately, retained securely and used only according to your wishes. We collect personal details necessary to communicate with you and manage our ongoing business relationship with you. If you have any questions about how your personal information is handled or distributed, or if you wish to receive a full copy of our full privacy policy, please contact our privacy officer.
16. I acknowledge receiving a copy of this Agreement.
17. I understand my rights and obligations as stated above. I confirm that I am the full age of nineteen years (unless otherwise indicated below) and that I have read and understood this release and waiver of liability and I am aware that by signing this Agreement I am waiving certain legal rights, including the right to claim damages which I or my heirs, executors, administrators, successors or assigns may have against {SchoolName}.
18. Right of cancellation (Monthly Memberships only): You may cancel a Monthly Membership Agreement from the day you enter the Agreement until 10 days after you receive a copy of this Agreement. You do not need a reason to cancel. To cancel, you must give notice of cancellation to:
{SchoolName}
{SchoolAddress1}
{SchoolCity}, {SchoolState} {SchoolZipcode}
Annual Memberships and Punch Card Memberships cannot be canceled and are non-refundable.
19. You may freeze your Monthly Membership for up to 2 terms (months) per calendar year. A service charge of $20 will be applied to the months on freeze. A written notice must be received by the academy via email or letter. Account freezes are not available to Annual Memberships nor Punch Card Memberships.
You must give notice of cancellation by a method that will allow you to prove that you gave notice, including registered mail, electronic mail, facsimile or personal delivery. If you send the notice of cancellation by registered mail, electronic mail, or facsimile, it doesn't matter if the seller receives the notice within the required period as long as you sent it within the required period. Also, Buyer or Buyer’s estate may cancel the monthly membership agreement if (1) of the Buyer or Member dies, (2) the Member becomes totally physically disabled for the duration of the contract, (3) the Seller’s facilities are moved to a location that is more than five miles from the original facilities, (4) Seller’s services are no longer available as provided in the contract because of Seller’s permanent discontinuance of operation. (5) Annual membership agreements must be completed for the length of the agreement.
