YCMA Membership Agreement

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This agreement is for Yuba City Martial Arts in Yuba City, CA.
Classes are provided in person.

Before participating in any class a “Release of Liability” needs to be signed once a year. This can be signed upon arrival to class.

Email *

Name (Payer or Parent/Guardian) *

Phone number *

Example: 555-555-5555

Secondary / Emergency Phone Number

Student Name(s) *

List all individuals (including yourself) who will be participating in classes.

Student Age(s) *

Payment Plan/ Frequency *

An invoice will be emailed to the above address upon submission & review of this form.
Payments and/or invoices are processed/ emailed on the 1st of each month. Payment is due upon receipt of the invoice if not enrolled in automatic payments.
Late fees will be applied for invoices not paid within 10 days of invoice delivery.

*Prepayment and discounts are not available for students of Core or South Sutter Charter Schools. Invoices will be emailed directly to the school upon receipt of active PO numbers for each student.

Automatic application of "10% Buddy Up" Discount on 2 or more enrollments. No

Monthly $120/ each

Prepay 3 Months/ each* (Save $30)

Prepay 6 Months/ each* (Save $60)

Prepay 12 Months/ each* (Save $140 + FREE Fuji Gi/ Uniform)

When does the student plan to start classes? *

Would you like to enroll in Automatic Payments? *

Payments will remain at the above listed price and will be charged at the specified frequency until informed otherwise. Yuba City Martial Arts will provide a 60-day notice of any pricing change(s).

Yes

Comments/ Questions

Submission Agreement *

By submitting this form, I am agreeing to be contacted by Yuba City Martial Arts for participation and/or membership reasons. I understand that martial arts is a contact sport and I or my student/child could be injured in the progress of participation.

By submitting this form, I agree to assume all risks and expenses due to an injury that may occur in my/my student/ child’s participation at Yuba City Martial Arts. I agree to hold Yuba City Martial Arts or anyone acting on its behalf, harmless in the event of an injury to myself/my child while participating under the supervision of the above business.

Agree

A copy of your responses will be emailed to the address you provided.

Submit

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