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Use this form to make changes to your adult program, like X Team.

PROGRAM CONTRACT CHANGE FORM

 

Please note, if you are canceling your contract, the final billing date will be the 1st of the final month of participation. Enrollment will continue through the end of the month. Please be sure to cancel by the 10th of the month to avoid future charges.


 

Questions/Concerns? Please contact your gym's Head Instructor:

Seattle: seattle-instruction@verticalworld.com (206) 283-4497 

North: north-instruction@verticalworld.com (425) 609-9020

The program coordinator will contact you if more information is needed.

 



First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
Parent or Guardian's Email Address
Email*
Confirm Email*
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.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
Program Location (Home Gym):*
North
Seattle
Program Name:*
X Team
Desired Change:*
Cancel Program
Update Contact Info (use text box below)
Other (please use comment box below)
If you selected "Update Contact Info" or "Other" please elaborate here:
If cancelling, please let us know why.*
Schedule Change
Sport Season Change
Finance Change
Other (please use comment box below)
If you selected "Other" please elaborate here:
If canceling from the X Team program, what is the last month you want to attend? Participants can only select their last month of participation as the current month if notice is given on or before the 15th. Cancellation is never retroactive. *
N/A
September
October
November
December
January
February
March
April
May
June
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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