REGISTRATION  
FOR ROCKLINE BASKETBALL ACADEMY
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Child's full name  *
Parent's full name *
Parent's phone # *
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Medical condition staff should know?
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How did you hear about us? *
Recommended by friend?  Name the friend below. 
LIABILITY WAIVER  Rockline Services LLC. MINOR WAIVER RELEASE OF LIABILITY FOR MINOR PARTICIPANTS IN CONSIDERATION of my child, being allowed to Participate in any way in the Rockline Services LLC. related events & activity. The undersigned acknowledges, appreciates, & agrees that: 1. The risk of injury to my child/ward from (ex: communicable diseases such as MRSA, influenza, and COVID-19) the activities involved in these programs is significant, including the potential for permanent disability & death, & while particular rules, equipment, & personal discipline may reduce this risk, the risk of injury does exist. 2. I FOR MYSELF, SPOUSE, & CHILD/WARD, I KNOWINGLY & FREELY ASSUME ALL SUCH RISKS, both known & unknown, EVEN IF ARISING FROM ANY NEGLIGENCE OF others, I assume full responsibility for my child/ward’s participation. 3. I willingly agree to comply with the program’s stated & customary terms & conditions for participation. If I observe any unusual significant concern in my child/ward’s readiness for participation & agree to bring such attention to the nearest official immediately. 4. I for myself, my spouse, my child/ward,  on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Rockline Services LLC &  its directors, officers, officials, agents, employees, volunteers, Coaches, independent contractors and  all other participants, sponsoring agencies, sponsors, advertisers, & if applicable, owners & lessors of premises used to conduct the event (“Releases”), WITH RESPECT TO ANY & ALL INJURY,DISABILITY, DEATH, or loss or damage to person or property incident to my child/ward’s involvement or participation in these programs, WHETHER ARISING FROM NEGLIGENCE OR OTHERWISE, to the fullest extent permitted by law.5. I, for myself, my spouse, my child’s/ward, & on behalf of my/our heirs, assigns, personal representative & next of kin. HEREBY INDEMNIFY & HOLD HARMLESS all the above Releases from any & all liabilities incident to my child’s/ward involvement or participation in these programs, EVEN IF ARISING FROM NEGLIGENCE, to the fullest extent permitted bylaw.6. Inclement weather session cancellations will not be rescheduled as this is to be expected. I HAVE READ THIS RELEASE OF LIABILITY & ASSUMPTION OF RISK AGREEMENT, I FULLY UNDERSTAND ITS TERMS, I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARY WITHOUT ANY INDUCEMENT . I understand the seriousness of the risks involved in participating in this program, my personal responsibilities for adhering to the rules & regulations & accept them as a participant.  If the recurring membership payment fails to process for any reason, I understand my child will not be able to participate until the membership is reactivated. Participation without an active memberships is not negotiable. I understand the the local site, Coaches or trainers do not and cannot override this policy.                                                                                                                                                                                                  *
Required
Parent / Guardian full name
will serve as electronic Signature 
Date of Acknowledgment "today's date"
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MEDIA RELEASE FORM

 I authorize the Rockline Basketball Academy of Rockline Services LLC. and any of its vendors to   make use of me and my child’s appearance on any and all forms of media including but not limited to photographs, recordings and video.

 I understand that the Rockline Services LLC.  And associated producers shall have complete ownership of the program media. I give Rockline Services LLC and all its producers the right to use my name, likeness and biographical material to publicize the program and the services of the Producer. I understand that I am volunteering my time and will receive no monetary compensation.

The Producer may:

 1.     Photograph me and record my voice and likeness for the purpose of the production mentioned above, whether by film, videotape, magnetic tape, digitally or otherwise;

2.     Make copies of the photographs and recordings so made;

3.     Use my name and likeness for the purposes of education, promotion or advertising of the sale or trading in the photographs, recordings and any copies so made. I further understand the master tape remains the property of the Producer and that there will be no restrictions on the number of times that my name and likeness may be used.

I understand that I cannot withdraw my consent after I sign this form and that this consent and release is binding on me and my heirs, legal representatives and assigns. 

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Required
Parent / Guardian full name
will serve as electronic Signature 
 *
Date of Acknowledgment "today's date"
 *
MM
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THIS IS ONLY AN EXPLANATION OF HOW THE 
MONTHLY CHARGE AGREEMENT   WORKS.  This is not a commitment to activate your membership.  The membership becomes effective once you decide to move forward and you make your 1st payment. 

 Once I choose the Academy membership & Pay, I authorize Rockline Services LLC. To auto deduct a monthly subscription fee from my debit or credit card. I understand the subscription fee is a recurring monthly charge to my account via the secured SQUARE link. This form is only for acknowledgement of the recurring charge process.  You will be able to process payment via the secured link "SELECT  MEMBERSHIP" button on the website.  

Rockline Services LLC. Is not responsible for missed practices due to the following but not limited to reasons; weather, holidays, illness etc.  Please note a $50.00 late fee will be applied within 24 hours if monthly membership charge is declined and the issue is not corrected. NOTE; contact us prior to, or within the first 24 hours to reconcile payment . Any payment, card update or academy withdraw can be made by clicking on the "manage subscription" button at the bottom of each month's emailed invoice. This includes any changes or updates to current card or if you are changing payment method.  If you choose to withdraw from the academy it is your responsibility to unsubscribe following the aforementioned "manage subscription" steps. 

****If the recurring membership payment fails to process for any reason, I understand my child will not be able to participate until the membership is reactivated. Participation without an active memberships is not negotiable. I understand the the local site, Coaches or trainers do not and cannot override this policy.  I accept and agree to the terms above. This includes agreement to not dispute the monthly charge once it is processed. I clearly understand i can unsubscribe at anytime prior to the charge being proceed.                                                                                                                                                                                                                               
 *
Parent / Guardian full name
will serve as electronic Signature 
 *
Date of Acknowledgment "today's date"
MM
/
DD
/
YYYY
"NO CHARGE BACK AGREEMENT"  This No Charge Back Agreement is between the membership payee and Rockline Services LLC.  The purpose of this Agreement is to outline the terms and conditions under which the membership payee agrees not to initiate a chargeback on any payments made to Rockline Services LLC. This term and condition of membership is once the payment has been processed there will be no refund provided. The member will be entitled to complete the rest of the month’s training lessons. Memberships are on a month-to-month basis and there are no penalties for cancelling. Memberships must be cancelled prior to the next payment date. Member can continue to participate until the day before the next billing day.
1. Acknowledgment of Payment -The Customer acknowledges that they have made a payment to Rockline Services LLC commits to prove. The Customer agrees that the payment is final and non-refundable, except as specified in the Company’s refund policy.
2. No Charge Back Commitment - The Customer agrees that they will not initiate or request a chargeback with their credit card issuer or any other payment processor for any payment made to the Company. The Customer understands that initiating a chargeback may lead to penalties, including but not limited to additional fees or legal action.
3. Dispute Resolution - In the event of any dispute or issue regarding the payment or services provided, the Customer agrees to contact the Company directly to resolve the issue. The Customer will provide a reasonable opportunity for the Company to address and resolve the dispute before seeking any chargeback or legal action.
4. Refund Policy - The Customer acknowledges that they have read and understood the Company’s refund policy. The Customer agrees to abide by the terms of the refund policy and accepts that the Company’s decision regarding refunds is final.
5. Legal and Financial Responsibility - The Customer agrees to be financially responsible for any chargeback fees or penalties incurred by the Company as a result of the Customer’s actions. This includes any costs associated with reversing a chargeback or resolving any disputes related to the chargeback.
6. Governing Law - This Agreement shall be governed by and construed in accordance with the laws of the state/country in which the Company is incorporated, without regard to its conflict of law principles.
7. Entire Agreement - This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, whether written or oral, relating to such subject matter.
8. Amendments - Any amendments to this Agreement must be made in writing and signed by both parties.
9. Acceptance -By signing this agreement below,  I confirm that I understand and agree to the terms and conditions of this No Charge Back Agreement.


Parent / Guardian full name
will serve as electronic Signature 
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