Sign Up - Pride Fighting Academy

PRIDEFIGHTINGACADEMY
2ROODEHEKHOUSE,ROODEHEKRD,GARDENSCAPETOWN
CKREGNO:2005/014832/23
CONTACTMIKE:0826602129
EMAIL:[email protected]
MEMBERSHIPPACK
Classesarebrokenupintotwomaincategories“StandUp”and“Ground”.Thestandupclasses
consistofboxingandMuayThaiandthegroundclassesofBrazillianJiuJitsu,,WrestlingandGround
&Pound.Fridaysareusedasanopenmixedsessionwherethemainfocusissparringandrolling.
Personaloneononetrainingisavailableandapackageforacombinationofgroupandpersonal
trainingcanbeputtogethertosuiteachindividual’sneeds.
TrainingSchedule:
Time
6:00am
10:00am
5:30pm
Monday
Boxing
BjjGi
5:30pm
6:30pm
MuayThai
Boxing
Boxing
Sparring
MuayThai
Boxing
Tuesday
MuayThai
NoGi
&mma
Wednesday
Boxing
BjjGi
Thursday
MuayThai
NoGi
&mma
Friday
Saturday
Sunday
BJJ
C
L
O
S
Boxing
Sparring
MMA
Bjjconditioning
Rolling
&Sparring
E
D
FEES&REGISTRATION:
AonceoffjoiningfeeofR300isrequiredonregistration.Adebitorderpaymentsystemis
mandatoryforallclients,unlessaminimumcontractperiodof6monthsispaidinfullinadvance.
PFABANKDETAILS
FNBCHEQUEACCOUNTNUMBER:62181941488BRANCHCODE:201511
CONTRACTS&PRICINGSTRUCTURE:
Allcontractsarepayablemonthlyviadebitorderorcashinadvanceonly.
MembershipfeeisR650permonthonthe6-monthcontractR580onthe12-monthoption.The
StudentRateisR580foraminimum6-monthcontract.Membershipallowsyoutotraineveryday
perweekforunlimitedgroupclasses.
TERMSANDCONDITIONS:
1. Payment must be made prior to attending class; there is a simple “no pay no train
policy”.
2. Missed classes cannot be made up or carried over into another month. You may however
deferamonth’strainingwiththepropernoticeandvalidreasonduetoinjury.
3. Astudentdiscountisapplicableonlytothosewithavalidstudentcard.
4. Contracts will continue to run after the contract period ends unless a
cancellation notice is given. Cancellation requires one calendar months’
noticetocancelthecontract.Membershipswillcontinuetorunmonthly
unlessawrittennoticeofcancellationisgiven.
5. PFA does not accept responsibility for any personal injuries or damage or loss of personal
property.
LIABILITY:
PFA,itsowners,employees,representativesandoragentsshallnotacceptliabilityforanyloss,
damageorinjuryofanynatureordeathwhetherrisingfromnegligenceorotherwisewhichis
sufferedbyanypersonwhoentersthepremises.
CONFIDENTIALITY:
TrainingmethodsandintellectualpropertygainedatPFAistobekeptconfidentialandisnottobe
taughttoanyonewhoisnotamemberofPFA.
MEMBERSHIP&INDEMNITYFORM:
Name:______________________________
Date:_______________
Surname:____________________________
IdentityNumber:______________________DateOfBirth:______________Age:___
Address:_______________________________________PostalCode:__________
:_______________________________________
POBOX:_______________________________________
PostalCode:___________
ContactNumbers:
Cell:____________________Home:____________________Work:__________________
EmailAddress:_______________________________________
InCaseOfEmergencyPleaseCall:____________________________on________________
MembershipOption:(pleaseticknextyourchoice)
Full:__ Student:__
DebitOrder:__CashUpfront:__
MembershipContractTerm:_________________StartingDate:_________________
MonthlyDebitAmount:____________CashAmount:_____________JoiningFee:_________
MedicalHistory: (PFAcannotandwillnotbeheldliableforanyinjuryorillnessthatarisesasa
resultofanyerrorsoromissionscontainedinthisform)
Listallhealthconditionsandinjuries:____________________________________________
___________________________________________________________________________
___________________________________________________________________________
Doctor:_______________________________________Tel:__________________________
MartialArtsBackground:_____________________________________________________
HowdidyouhearaboutPFA?__________________________________________________
ACCEPTANCE:
ItheundersigneddoherebyacknowledgeandagreethatthetrainingfacilitiesprovidedbyPFAhave
specificallybeenformulatedtoensuremysafetyandencouragethebestpossibleresultsfrom
regulartraining.Ihavereadthetermsandconditionsofmembershipandagreetoalltherulesand
regulationsstipulatedtherein.
IfurtherconfirmthatIhaveconsultedmyphysicianondoctorpriortocommencingtrainingatPFA.
Novariation,indulgenceorwaivercanaltertheabovementionedtermsandconditionsofthisagree
ment.
I,__________________________________________(name&surname)havefamiliarizedmyself
withtherulesandregulations,alongwiththemembershiptermsandconditionsofPFAandhereby
agreetobeboundthereby.
MembersSignature:__________________
Date:_____/_____/_____
Ifyouareunder21yearsofagepleaseensurethatyourparentorguardiansignsonyourbehalf.
Parent/GuardianSignature:____________
Date:_____/_____/_____
FullNameofGuardian:__________________________________IDNo:_______________
Contactnumber:________________________
BANKDEBITORDERINSTRUCTION/CREDITCARDAUTHORITY:
Name:
_____________________
Date:
______________________
ContractNo.:
______________________
_____________________
DebitAmount:
______________________
_____________________
Commencement
______________________
Date:
_____________________
Abbreviated
name
as
PRIDEFIGH
registered with
thebank:
Address: _____________________
Contact
No:
DearSirs/Madams
Thedetailsofmy/ouraccountareasfollows:
BANK:
________________________
CARDHOLDERS
NAME:
________________________
BRANCH
________________________ CARDNUMBER: ________________________
TOWN:
BRANCH
________________________ EXPIRYDATE:
NO.:
________________________
ACCOUNT
________________________ CVVNUMBER:
NAME.:
________________________
ACCOUNT
________________________
NO.:
(three digit number on back
ofcard)
TYPE OF
________________________ CARDTYPE:
A/C:
________________________
(mastercard,visa)
ThissignedAuthorityandMandatereferstoourcontractasdatedasonsignaturehereof
("theAgreement").I/Weherebyauthoriseyoutoissueanddeliverpaymentinstructions
to the bank for collection against my / our abovementioned account at my / our above
mentioned bank (or any other bank or branch to which I / We may transfer my / our
account) on condition thatthe sumofsuch payment instructions willneverexceedmy /
ourobligationsasagreed to in theAgreement,andcommencingonthe commencement
dateandcontinuinguntilthisAuthorityandMandateis terminatedby me/usbygiving
you notice in writing of no less than 20 ordinary working days, and sent by prepaid
registeredpostordeliveredtoyouraddressindicatedabove.
The individual payment instructions so authorised to be issued must be issued and
deliveredasfollows
i. On the _______ day ("payment day") of each and every month commencing on
_____________. In the event that the payment day falls on a Saturday, Sunday or
recognized South African public holiday, the payment day will automatically be the very
next ordinary business day. Further, if there are insufficient funds in the nominated
account to meet the obligation, you are entitled to track my account and re-present the
instructionforpaymentassoonassufficientfundsareavailableinmyaccount;
ii.Monthly;onorafterthedateswhentheobligationintermsoftheAgreementisdueand
the amount of each individual payment instruction may not be more or less that the
obligationdue;
I / We understand that the withdrawals hereby authorised will be processed through a
computerized system provided by the South African Banks and I also understand that
details of each withdrawal will be printed on my bank statement. Each transaction will
containanumber,whichmustbeincludedinthesaidpaymentinstructionandifprovided
toyoushouldenableyoutoidentifytheAgreement.Apaymentreferenceisaddedtothis
form before the issuing of any payment instruction. I / We shall not be entitled to any
refund of amounts which you have withdrawn while this authority was in force, if such
amountswerelegallyowingtoyou.
MANDATE:
I/Weacknowledgethatallpaymentinstructionsissuedbyyoushallbetreatedbymy/our
abovementionedbankasiftheinstructionshadbeenissuedbyme/uspersonally.
CANCELLATION:
I/WeagreethatalthoughthisAuthorityandMandatemaybecancelledbyme/us,such
cancellation will not cancel the Agreement. I / We shall not be entitled to any refund of
amounts which you have withdrawn while this authority was in force, if such amounts
werelegallyowingtoyou.
ASSIGNMENT:
I/WeacknowledgethatthisAuthoritymaybecededtoorassignedtoathirdpartyifthe
agreement is also ceded or assigned to that third party, but in the absence of such
assignmentoftheAgreement,thisAuthorityandMandatecannotbeassignedtoanythird
party.
Signed at _________________ on this _________________ day of _________________
20___
DECLARATION:
Do you authorise _____________________________ to issue
and deliver payment instructions to your Banker for collection
against your Bank account on condition that the sum of such
payment instruction will never exceed your obligations as
agreedinyourcontract/agreement?
This method will commence effective (date) and will continue
monthly, thereafter until your obligation has ended or the
Authority and Mandate is terminated by yourself by giving us
noticeofnotlessthanonemonth.
In the event that the payment day falls on a Sunday or
recognised South African public holiday, the payment day will
automaticallybetheverynextordinarybusinessday.
Ifthereareinsufficientfundsinthenominatedaccounttomeet
the obligation, we are entitled to track your account and representtheinstructionforpaymentassoonassufficientfunds
areavailableinyouraccount.
ThisAuthorityandMandatemaybecancelledbyyouhowever;
such cancellation will not cancel the Agreement. You shall not
be entitled to any refund of amounts which we may have
withdrawn while this Authority was in force, if such amounts
werelegallyowingtous.
TheAuthorityandMandatemaybecededorassignedtoathird
party only if the Agreement is also ceded or assigned to the
thirdparty.
Please note that the reference that will appear on your bank
statementwillbe
________PRIDEFIGH_______
Mr/Mrs/Miss ______________________we will confirm your
AuthorityandMandateinwritingpriortoprocessingthedebit
orderagainstyouraccount.
Mr/Mrs/Miss _________________ do you understand and
accept what I have read to you? (Yes/No) If you have any
questions or complaints, please contact________________ on
________________.