Martial Arts World & Fitness Center Membership Agreement

Pre-Black Friday 50% Off Enrollment
Membership Type *

Primary Member

The responsible party for this agreement. Must be 18+ to fill out this section.

Additional Household Members

Usually the enrolling minor(s). Can also be adult(s) who is not the responsible party for this agreement.

Emergency Contact Informatiomn

Enrollment Payment

Recurring ACH Authorization

You authorize scheduled monthly charges to your checking/savings account. You will be charged the amount according to your membership plan each billing period. A receipt for each payment will be provided to you and the charge will appear on your bank statement as an "ACH Debit." You agree that no prior notification will be provided unless the date or amount changes, in which case you will receive notice from us at least 7 days prior to the payment being collected.

Billing Information

Bank Details

Account Type *
I understand that this authorization will remain in effect until I cancel it in writing and I agree to notify VSK Jiujitsu Institute II, Inc. in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted payment dates fall on a weekend of holiday, I understand that the payments may be executed on the next business day. For ACH debits to my checking/savings account, I understand that because these are electronic transactions, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non-Sufficient Funds (NSF), I understand that VSK Jiujitsu Institute II, Inc. may at its discretion attempt to process the charge again within 30 days, and agree to an additional $25.00 charge for each attempted returned NSF which will be initiated as a separate transation from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. Law. I certify that I am an authorized user of this bank account and will not dispute these scheduled transactions with my bank; so long as the transactions correspond to the terms indicated in this authorization form.
Account Holder Signature *
I certify that I have read and agree to Martial Arts World & Fitness Center Membership Terms & Conditions *