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Salt Pump Portsmouth

199 Constitution Ave.

Portsmouth, NH  03801

(603) 368-1019

info@saltpumpclimbing.com

Salt Pump Portsmouth EFT Agreement


Thank you for signing up as an EFT member. Before you enjoy all the great perks that come with being a member, here are a few things you need to know:

  • Salt Pump will keep credit card info on file in order to charge your monthly dues and any item invoiced to your account.
  • If you DO NOT want to keep your card on file with us for automatic monthly payments, please ask our staff about our pre-paid membership options
  • You must have current contact information on file (email and phone).
  • You will be billed the agreed upon membership dues plus any "on account" items on the 1st of every month until you cancel using the method below.
  • Any changes to your account need to be made by the 25th of the month if you do not want your membership to renew for the next month.
  • Any changes must be made online using our Membership Change Form (easily found on the website!).
  • If you cancel your membership, any "on-account" items will be charged at the time of cancellation.
  • No refunds will be given for past months.
  • No prorated months if terminating mid-month.
  • There is no cancellation or initiation fee.
  • You can freeze your EFT membership (at no charge) for up to 3 months, once per year. 
  • All freeze requests must to be submitted using our Membership Change Form by the 25th of the month to freeze for the following month. 
  • Your existing dues amount will be preserved during a freeze.
  • Your membership will automatically bill after your freeze has ended.
  • If you'd like to return prior to the end of your freeze, feel free to come into the facility and we'll be able to restart your membership. 
  • Discounts for families, students, youth, military, 65+, and AAC members cannot be combined with other discounts.
  • Family memberships must all be billed from the same card on file - the account to be billed will be set to the 1st member and any additional accounts will be linked to this member.
  • If you miss a payment or your card gets declined, we will send you a follow up email.
  • If you come in with an outstanding balance, we'll ask you to update your card and charge your membership dues and any "on account" items immediately.
  • 2 months of outstanding payments will result in your membership automatically terminating.
  • Any questions or concerns:
  • Email info@saltpumpclimbing.com
  • Call (603) 368-1019

 

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*
Middle Name
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
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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