1755 N. Golden Hills Drive, Bldg #4, Palmer 907-232-8052

1755 N. Golden Hills Drive, Bldg #4, Palmer 907-232-8052

ENROLLMENT CONTRACT

Athlete Name: ______AUSAW # ______

Athlete DOB: ____/____/____Athlete Email: ______

Name of Legal Guardian (if athlete is a minor):

______

6 - Month Contract

*One-time Registration Fee for all members: $40.00*

[ ] Intro to Wrestling Only - $95 per month

[ ] Advanced Wrestling Only - $95 per month

[ ] Jiu Jitsu Only - $95 per month

[ ] Wrestling/Jiu JitsuUnlimited - $140 per month

Additional Options:

[ ] Punch Card (10 classes) - $130.00 (Auto billing does not apply)

[ ] Per Class - $15.00 (Auto billing does not apply)

*Military Discount: 10% (Excludes punch cards, per class, and merchandise)

*Family Member Discount – ask Management for details

I hereby agree to enroll the above-named athlete into Pioneer Grappling Academy, beginning on the above Contract Start Date and continuing for the contract period I have selected above (the “Minimum Contract Period”). After the Minimum Contract Period is over, this contract will automatically renew each month on a month to month basis unless cancelled according to this contract. I cannot terminate this contract before the expiration of the Minimum Contract Period, but I can terminate this contract at any time after expiration of the Minimum Contract Period by giving not less than 2 weeks written notice of cancellation.

I agree I will pay all amounts required to be paid under this contract regardless of the number of classes the Athlete attends, and even if the Athlete is unable to attend. Without limiting the preceding sentence, I agree I will pay all amounts required to be paid under this contract even if the Athlete is prevented from attending as a result of an injury sustained in class.

Without limiting the foregoing, I agree to authorize my MasterCard/Visa Card for automatic billing for the term (including any renewals) of this contract or until the expiration of my credit card, whichever is shorter. If and each time my credit card expires while this contract (including any renewals) is ongoing, I agree to re-authorize my MasterCard/Visa Card for automatic billing. If my card number or expiration date changes on my card I agree to provide that information to Pioneer Grappling Academy, so that no payments are missed. Even if I cancel my credit card I agree I am responsible for all payments required in this contract. Failure to pay will result in reporting to the credit/collection agencies. In the event that a credit card payment is rejected or declined I agree to pay a $30 charge. Additionally, any other costs that are incurred by the academy as a result of a rejected or declined transaction in excess of $30 will be charged to me. I agree this charge can be made on my credit card.

I understand and agree that this contract is not effective unless and until (1) it is signed by Pioneer Grappling Academy, and (2) the Athlete (or, in the case of a minor, his/her legal guardian) signs and returns the attached Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement.

Pioneer Grappling Academy Brazilian Jiu Jitsu Programactivities will be directed to and handled by its Director, Paul Sturgeon. Pioneer Grappling Academy Wrestling Program, to include any further programs added, will be directed to and handled by Vince and/or Maria Cramer.

Printed Name:______

Signature:______Date: ______

Address: ______

Telephone:______

Accepted by:

Pioneer Grappling Academy, LLC

Signature:______Date:______

Its:______

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