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Tiger Rock Martial Arts After-School Club Sign-Up

After-School Club Expenses:

  • Start-Up: $38 includes training uniform (dry-fit shirt, pants, and belt).
  • Monthly Dues: $69 (starting Sept. 15th) includes one class a week at your elementary school, plus one extra class a month at the Tiger-Rock Academy.  

  • Monthly Dues will auto-draft from your card on file on the 15th of each month (see below). You must contact your instructor in order to cancel your program. 

    • 1st Semester Tuition Payments: Sept. 15, Oct. 15, Nov. 15

    • 2nd Semester Tuition Payments: Jan. 15, Feb. 15, Mar. 15

  • Testing fee: $70.00   Testing is at the end of each semester (Dec. & April).

 

After-School Club Policies:

  • Pick-up time will be designated by your club's instructor. A parent or guardian must be at the elementary school to pick up your child at the designated time unless your child is in the extended day program. There is a charge of $1 per minute you are late to pick up your child.
  • The martial arts class is a place for positive action and communication. If you have any concerns or problems talk only with your child's instructor. Negative comments and gossip are destructive and are not tolerated.
  • Students are required to have a uniform.
  • If the elementary school is closed for any reason, we will not have martial arts lessons. You can make up your missed classes at the Tiger-Rock Academy.

 

Authorization for Automatic Payments:

I/We hereby authorize the designated billing company selected by the academy to draw items (checks, electronic funds, charge card) for the purposes of paying academy dues, service fees, academy belt rank exam fees, sponsored events, and other purchases associated with this membership.

I/We understand that I/We are responsible for advising the academy of any changes in my checking account or credit card infonmation. I understand that should my credit card be declined or there be insufficient funds in my checking account, I/We will be subject to any additional fees allowed by state law for insufficient funds.

The academy and Tiger-Rock MAI Systems, Inc. reserve the right to cancel these services at any time for any reason.

 

 

AGREEMENT OF RELEASE

“RELEASED PARTIES” AS USED HEREIN MEANS THE ACADEMY, BIRMINGHAM TKD, INC., PELHAM TRMA, TIGER ROCK MARTIAL ARTS INTERNATIONAL (TRMAI), THEIR AGENTS, SERVANTS, EMPLOYEES, DIRECTORS, STUDENTS AND INSTRUCTORS.

I, or the minor participant(s), will be voluntarily participating in a TaeKwonDo class, Brazilian Jiu-Jitsu, Native Korean Sword class, HanMuDo class, Xtreme Performance (XP) and/or Extreme TaeKwonDo class (all herein referred to as “Activity”) and may attend events associated therewith.  I understand that such Activity is a contact sport and has the potential for serious physical injury. In recognition of the possible dangers connected with this contact sport, and in consideration of the instruction in the Activity which I or the minor participant(s) shall be receiving from Released Parties, I am voluntarily signing this agreement to waive any right or claim I may have arising out of the instruction of my, or the minor participant(s)’s, participation in any Activity.  I am releasing Released Parties from any and all liability, including medical and health care expenses, for any injury or damage to me or to the minor participant(s) arising out of or in any way connected with the instruction or participation in an ActivityEVEN IF THE INJURY OR DAMAGE IS CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OR OTHER FAULT OF ONE OR MORE OF THE RELEASED PARTIES.

I, in consideration of the services of The Academy, the rate charged for those services and the right to engage in activities at The Academy and/or TRMAI as a participant, hereby acknowledge, agree, promise and covenant with RELEASED PARTIES, and all other persons or entities which may be connected to or with The Academy, or TRMAI as follows:

I HEARBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE RELEASED PARTIES from all liability to me, or minor participant(s), my, his or her personal representatives, assigns, heirs, and next of kin for any and all loss, injuries, or damage, and any claim or demands therefore, on account of injury, death, or illness to me or minor participant(s).  WHETHER CAUSED BY NEGLIGENCE OF THE RELESAED PARTIES OR OTHERWISE while I, or minor participant(s), am participating in any Activity or event of The Academy or TRMAI, whether it be active participation or mere observance.

I ACKNOWLEDGE, UNDERSTAND AND APPRECIATE THE INHERENT RISKS, KNOWN AND UNKNOWN, WHICH MAY BE INVOLVED IN THE PARTICIPATION OF ANY ACTIVITY IN THE ACADEMY AND TRMAI, INCLUDING BUT NOT LIMITED TO RELEASED PARTIES’ SPONSORED EVENTS OCCURRING OFF THE ACADEMY OR TRMAI PREMISES, EVENTS WHICH BY THEIR NATURE INCLUDE INTENSE, STRESSFUL, AND STRENUOUS EXERCISES AND BODY CONTACT. I FURTHER EXPRESSLY CONSENT, UNDERSTAND AND RECOGNIZE THAT THESE RISKS MAY RESULT IN SERIOUS INJURY OR ILLNESS INCLUDING BUT NOT LIMITED TO: BRUISES, BLOODY NOSES, BROKEN BONES, HEART ATTACKES OR OTHER CARDIOVASCULAR DISEASE, OR OTHER SERIOUS INJURY THAT CAN RESULT IN DEATH.  I FURTHER UNDERSTAND AND ACKNOWLEDGE THAT THESE RISKS MAY RESULT IN PERSONAL CLAIMS AGAINST RELEASED PARTIES, OR CLAIMS AGAINST ME BY OTHER PARTICIPANTS OR OTHER THIRD PARTIES.  I EXPRESSLY COVENANT NOT TO SUE THE RELEASED PARTIES FOR ANY DAMAGES OR INJURIES WHICH MAY RESULT FROM MY OR THE MINOR PARTICIPANT(S)’S PARTICIPATION IN THE ACADEMY OR TRMAI.

I ASSUME FULL RESPONSIBILITY FOR ALL RISK OF BODILY INJURY, INCLUDING BUT NOT LIMITED TO: BRUISING, BLOODY NOSES, HEART ATTACKS OR OTHER CARDIOVASCULAR DISEASE, OR OTHER SERIOUS INJURY THAT CAN RESULT IN DEATH DUE TO THE NEGLIGENCE OF RELEASED PARTIES, WHILE PARTICIPATING IN ANY ACTIVITY OR EVENT OF THE ACADEMY OR TRMAI.

I EXPRESSLY ACKNOWLEDGE AND AGREE THAT THE ACTIVITIES OF THE ACADEMY AND TRMAI MAY AND CAN BE DANGEROUS AND INVOLVE THE RISK OF SERIOUS INJURY OR ILLNESS AND/OR DEATH AND/OR PROPERTY DAMAGE.  I, OR MINOR PARTICIPANT(S) ACCEPT AND ASSUME THESE RISKS.  I agree that this agreement of release is intended to be as broad and inclusive as is permitted by the laws of the State of Alabama or the law of the state in which the event(s) is conducted.

I release RELEASED PARTIES from any and all liability, including but not limited to medical or other health care expenses, for any injury or damage to me or to the minor participant(s) occurring on or around the premises of The Academy or TRMAI during times even when I or minor participant(s) are not participating in any Activity. EVEN IF THE INJURY OR DAMAGE IS CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OR OTHER FAULT OF ONE OR MORE OF THE RELEASED PARTIES.

I agree to abide by all rules and regulations of The Academy and TRMAI.  I acknowledge and affirm that I, and/or the minor participant(s), are in good physical condition and do not suffer from any disability or other condition whatsoever which would prevent or limit participation in The Academy and TRMAI.

I HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS RELEASED PARTIES FROM ANY LOSS, LIABILITY, DAMAGE, INJURIES, COSTS (INCLUDING ATTORNEY FEES) THAT MAY INCUR AS A RESULT OF MY , OR THE MINOR PARTICIPANT(S)’S, PARTICIPATION IN ANY ACTIVITY OR EVENT OF THE ACADEMY OR TRMAI, OR THAT MAY ARISE ON THE PREMISES OF SUCH ACTIVITY OR EVENT, EVEN IF THE INJURY OR DAMAGE IS CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OR OTHER FAULT OF ANY OF THE RELEASED PARTIES.

In the event that any provision hereof shall be adjudged by a court of competent jurisdiction to be invalid, illegal or unenforceable, such invalidity, illegality or unenforceability shall not affect the remaining provision, and this agreement of release shall be construed to the extent possible as if such invalid, illegal or unenforceable provision, or part thereof, had never been contained herein.

I understand the terms of this agreement and accept responsibility for all costs of any litigation arising from this agreement, including a reasonable attorney’s fee.

I have read this agreement of release and have had the opportunity to have it reviewed by an attorney, I understand and agree to all of its terms and provisions.  All of my questions have been answered.  I clearly understand all of the risks involved in any Activity. There are no oral statements or representations made to me not contained in this agreement.  I UNDERSTAND THAT IF I OR THE MINOR PARTICIPANT(S) IS HURT, I WILL HAVE NO RIGHT TO MAKE CLAIM OR SUE ANY OF THE RELEASED PARTIES. 

I understand and acknowledge that this agreement of release and any prior agreements of release executed by me shall apply to me or the minor participant(s)’s current involvement in the Activity and will be binding on me and the minor participant(s) in any subsequent renewal of my membership with any of the RELEASED PARTIES.

PARTICIPANT/PARENT OR GUARDIAN: THIS DOCUMENT AFFECTS YOU AND/OR YOUR CHILD’S LEGAL RIGHTS. YOU MUST READ AND UNDERSTAND THIS AGREEMENT BEFORE SIGNING IT.

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 19 years of age or older
First Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Billing: Debit/Credit Card Info

Name on card *

Card Number *

Exp. Date *

CCV# *
Text Messaging [Your instructor's main method of contact will be via text message. Please provide your cell number and carrier below.]

Parent/Guardian Cell Number *

Name Pickup Person Other Than Parent

Cell Number of Pickup Person (other than parent)
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*
Parent or Guardian's Date of Birth*
I certify that I am 19 years of age or older
Parent or Guardian's Information
Elementary School*
Grade*
Shirt Size*
Does child go to extended day (after-school care)?*
No
Yes
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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