Bootcamp Agreement.doc - BRIDGEWATER MARTIAL ARTS 27 PERKINS ST,BRIDGEWATER MA 02324(508 697 4947 MEMBERSHIP AGREEMENT Name_Gender_Date of Birth Address

Bootcamp Agreement.doc - BRIDGEWATER MARTIAL ARTS 27...

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BRIDGEWATER MARTIAL ARTS, 27 PERKINS ST.,BRIDGEWATER , MA 02324 (508) 697 - 4947 MEMBERSHIP AGREEMENT Name________________________________Gender____Date of Birth____________________ Address______________________________ City ________________State____ZIP__________ Home Phone_______________Other Phone_________________Employer_________________ Emergency Contact________________________________________Phone_________________ How did you hear about the fitness center?________________ Email:_____________________ MEMBERSHIP FEES Bootcamp Fee $________________________________ EFT or Credit Card Paid Today: _____________Enrollment Fee _____________Current month pro rate, and payment for the month of _______ _____________Subtotal _____________Total Paid today via:_____Cash_____Check AGREEMENT FOR EASY – PAY DEBIT SYSTEM I authorize Bridgewater Martial Arts to bill my bank account or credit card for my dues by electronic funds transfer (EFT), pre-authorized check or credit card charge. Our dues are processed by Twin Oaks Software Development, a $20 service fee will apply to all delinquent accounts. Your account will be billed upon minimum participant requirements. Member Initials___________ ( Must be initialed by the person who is providing the payment method.) The club will bill your (please circle): Visa MC Discover AMEX Checking Savings Bank name________________________________Routing #_______________________ Account #_______________________________Credit card Exp date________________ Name as it appears on the check/credit card______________________________ PLEASE ATTACH VOIDED CHECK IF APPLICABLE BUYERS RIGHT TO CANCEL If you wish to cancel this contract, you may cancel by mailing a written notice by certified or registered mail to the club. The notice must say that you do not wish to be bound by this contract and must be delivered or mailed before
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  • Spring '15
  • Credit card, club, Membership Agreement, bridgewater martial arts

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