Tiger-Rock Martial Arts of Frisco—Legacy Dr. 4060 Legacy Dr., Suite 301, Frisco, TX 75034 Customer Name(Required) Customer Address(Required) City(Required) State(Required)TexasAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code(Required) Primary Customer Phone Number(Required) Secondary Customer Number Email(Required) Number of Students Being Enrolled(Required)1234If you are also signing up for a membership, please include yourself.Student 1 Name(Required) Student 1 Birthday(Required) MM slash DD slash YYYY Student 2 Name Student 2 Birthday MM slash DD slash YYYY Student 3 Name Student 3 Birthday MM slash DD slash YYYY Student 4 Name Student 4 Birthday MM slash DD slash YYYY Your Monthly Tuition(Required)Date of First Payment Is your billing address the same as above?(Required)YesNoBilling Street Address(Required) Billing City(Required) Billing State(Required)TexasAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code(Required) Billing Phone Number(Required) Second Billing Phone Number Please select your method for payment for your membership fees.(Required)Please selectCredit/Debit CardBank DraftYour Credit Card Number(Required) Card Type(Required)VisaMasterCardDiscoverAmerican ExpressExpiration Date(Required) CVV Code(Required) Billing Zip Code(Required) Bank Name(Required) Routing Number(Required) Account Number(Required) Cancellation Policy(Required)I understand that this is a continuous membership with no expiration date and no built-in termination date. You may cancel this membership at anytime with a 60-DAY WRITTEN NOTICE. Intent to cancel must be done by completing the MEMBERSHIP TERMINATION FORM provided by and presented in person to this Tiger-Rock Martial Arts academy. Cancellation of membership will not be accepted via telephone, voice mail, text messaging, email, or other electronic communication, no exceptions. Final payment for the remaining days of membership will be due regardless of participation. RELOCATION: You may cancel this Auto-Pay Agreement if you relocate 10 miles or more from this Tiger-Rock Martial Arts location. Proof of relocation is required and a non-negotiable $50 EARLY TERMINATION PROCESSING FEE will be applied. MEDICAL TERMINATION: If a member becomes medically unable to participate in martial arts, this membership may be canceled with a WRITTEN DOCTOR’S ORDER and a non-negotiable $50 EARLY TERMINATION PROCESSING FEE will be applied. I agree to the cancellation policy.Other Expenses(Required)I acknowledge that there will be additional required expenses as part of this Tiger-Rock Martial Arts membership. I understand that additional expenses such as, but not limited to, COMPETITION FEES, BELT EXAM FEES, SAFETY GEAR, and TRAINING EQUIPMENT will be required, in addition to the monthly dues over the lifetime of this membership. Please note that monthly dues are subject to change. Late fees and/or insufficient funds will be assessed to the buyer. Please check here if you acknowledge that there are additional required expenses as part of this Tiger-Rock Membership.Signature(Required)With my signature, I am authorizing TIGER-ROCK MARTIAL ARTS to automatically draft my credit/debit card or my bank account as indicated for dues and services. I agree not to dispute any charges nor will I execute any “chargebacks” according to the Terms of this AutoPay Agreement. This agreement is governed by Texas law and is performable in the county in which the academy is located.Signature Date(Required) MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.