Brazier Sports & Fitness - Member Registration Form.

Member Registration Form

Please fill out the your/your child's details
Member Info
Member's Name*

First NameLast Name
Birth Date*

DayMonthYear
Primary E-Mail (Note: this is the email account that will receive invoices)*
example@example.com
Primary Mobile Number*

Area CodeMobile Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Subscription For*
2nd Member's Name*

First NameLast Name
2nd Member's Birth Date*

DayMonthYear
Do you or your child have any medical restrictions preventing participation in intense physical activities?*

YesNo
Please let us know if your child born with special needs or is he/she facing any challenges in that topic?

YesNoNot applicable (student over 18 years old)
If "yes" to any of the question above, please leave a comment.
Please choose a start date:

DayMonthYear
Date

Parents / Guardians Information

For under 18 years old student's subscriptions only*
Mom's/Female Guardian name

First NameLast Name
Mom's E-mail
example@example.com
Mom's Phone Number
Dad's/Male Guardian Name

First NameLast Name
Dad's E-mail
example@example.com
Dad's Phone Number

Brazier Sports & Fitness Ltd. Membership Agreement

Please read the carefully the bellow information before submitting this form
PRINCIPAL TERMS

This agreement commences once you have indicated your acceptance in the Declaration Term.
Your membership starts immediately unless you select a deferred Start Date.
You will be entitled to all the rights and privileges for the type of membership chosen.
You cannot transfer this agreement to anyone else.
You must be 18+ to obtain a Brazier Sports & Fitness Ltd. Membership. Anyone under this age is prohibited from using the online order system.
Payments on the online order website are by debit or credit card only.

WAIVER

Recognize and understand that martial arts training is a physical contact activity and that my participation might result in serious injury, including permanent disability or death and severe social and economic loss.
Recognize and understand that such risk may be due to, not only my own/my child’s actions but also the action, inaction, or negligence of others, the regulations of participation, the conditions of the premises, or of any of the equipment used.
Recognize that there may be other risks that are not known to me/my child’s or to others or not reasonably foreseeable at this time.
Agree to inspect the facilities, equipment, and pairings prior to participation. I will immediately inform an instructor of the institute if I believe that anyone is unsafe or beyond my/my child’s capability and refuse to participate/allow my child to participate.
Assume all the foregoing risks and accept personal responsibility for any damages that may result from injury, permanent disability, or death.
Enter martial arts training and competition entirely of my own free will and understand the importance of following the rules of training and competition. I have been given the rules and regulations of Team Brazier Sports & Fitness Ltd. and agree to abide by the instructions given.
Certify that I/my child has good health condition, and have no disease, injury, or other condition that would impair my/his/her performance of physical and mental well-being during intense training practice and/or competition.
Grant permission in case of injury to have a doctor, nurse, athletic trainer, or other emergency medical personnel provide me/my child with medical assistance or treatment for such injury.
Release, waive, discharge, and covenant not to sue Brazier Sports & Fitness Ltd., affiliated organizations and participants, supervisors, coaches, sponsoring organizations or their agents, and if applicable, owners and leasers of the premises from any and all liability to the undersigned, his or her heirs and next of kin for any and all claims, demands, losses, and damages which may be sustained and suffered on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise.

PHOTO RELEASE

I hereby grant Brazier Sports & Fitness Ltd. permission to use my or my child’s image in a photograph, photographs, or video recordings in any and all of its publications, including website entries and promotional materials, without payment or any other consideration. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph, photographs, or video recordings. I understand and agree that these materials will become the property of Brazier Sports & Fitness Ltd.

FEES AND CHARGES

The Registration Fee and the first month’s membership fees are collected by credit card/debit card (whichever you choose) on your membership application date. These fees are non-refundable under any circumstances other than in the event of a breach of negligence by us.
The first month’s membership fees will be charged proportionally to the number of days from your selected start date until the last day of the same month.
From the 1st day of the following month onwards, the normal fee for the full month shall be charged.
In the event that you decide to cancel your subscription before the 30-day period from your start date has been completed, an additional payment will be collected from your card to cover the remaining portion of the month, ensuring that you have paid for a full 30 days. This additional payment will be calculated based on the daily rate of your chosen membership.
Your monthly payments will continue automatically, starting from the 1st day of each month unless you notify us of your intention to cancel your membership.
If you wish to amend your payment method, please contact hello.ie@brazierjiujitsu.com, and it must be made at least 72 hours before your payment is due.
You agree to advise us promptly of any changes to the Member's Details provided.
The monthly payments made are non-refundable. If a payment is not received on the due date, once it is received prior to the cancellation of the membership, it will be backdated to the due date as this date is linked to your membership start date.
If any monthly membership fee is returned unpaid or if any other form of payment is not honoured, we will send you an email informing you of the bounced payment. You will have 72 hours to make the payment before the late payment fee of €10 is applied, and your access will be suspended.
In the event of access suspension due to late payment, you will be required to contact us to make payment, including the late payment fee, by credit card/debit card within 21 days to reactivate access and avoid paying the joining fee of €20. Failure to pay within this 21-day period will result in the cancellation of your membership.
Non-payment will result in your account being automatically cancelled, and a registration fee will apply again if you wish to rejoin.
Monthly Memberships can be paused for a maximum period of 30 days within a 12-month period, provided that members give us at least 72 hours' notice before the intended pause start date. A pause fee of €10 will apply for adult classes. For kids classes, the pause fee will be 50% of the Kids monthly membership fee.

CANCELLATION POLICY

To cancel your membership subscription, you must notify us at least 72 hours before the next billing period to avoid being charged for the upcoming month. If the notice is given less than 72 hours before the next billing period, the cancellation will take effect the following month, and you will be charged for the upcoming month.
DO NOT E-SIGN UNTIL YOU HAVE READ THE ABOVE STATEMENT. By my eSignature below, I certify that I have read, fully understand and accept all terms of the foregoing statement.
Waiver of Liability Signature*

I accept the terms listed in the agreement above
I acknowledge that I have been informed of the inherent risks associated with training in Jiu Jitsu and I fully understand and accept these risks. In consideration of being allowed to participate in Jiu Jitsu activities, I hereby release Brazier Sports & Fitness Ltd., its directors, instructors, volunteers, other clients, and agents from any and all actions, claims, liabilities, losses, costs, and expenses arising from injuries or damages sustained while participating in Jiu Jitsu activities. I further declare that the information I have provided is accurate and complete.
Submission Date

DayMonthYear
Date
eSignature*
For student's under 18 years old subscription, this field must to be signed by his/her PARENT or GUARDIAN*
Signature*

Clear
Please verify that you are human*
Should be Empty:

Member Registration Form

Member Info

Parents / Guardians Information

Brazier Sports & Fitness Ltd. Membership Agreement