New Member Registration Form

MEMBERSHIP REQUEST FORM
BACKGROUND CHECK POLICY

Please do not apply for membership to NexJen BJJ if you are not willing to complete a background check as part of enrollment.

While running background checks on our members may seem excessive, our purpose is twofold; first, we are committed to providing a safe environment for the children who train here and peace of mind for their parents. Secondly, we want to ensure that persons who have violent felony offenses* in their history are not receiving training that could be used to harm others.

NexJen BJJ WILL NOT refund enrollment fees paid if the potential member refuses to complete a background check or an adverse report that would preclude membership is returned.

*felonies, offenses involving minors, and/or assault, battery, etc

NOTE An applicant with a conviction for misdemeanor charges will not necessarily be disqualified from membership; please speak with Coach Tabscott PRIOR to beginning the enrollment process.

Background checks are not required for active duty military, active duty first responders and minors under the age of 18

ClearChecks Information Security & Privacy procedures can be found HERE
Please acknowledge our background check policy by selecting an option below:*

Yes, I agree to complete a background check as a condition of membership with NexJen BJJ and Martial Arts.The applicant is a minor, first responder or active duty military and not subject to a background check.No, I will not complete a background check.
MEMBERSHIP PLAN SELECTION

Prices shown below include a one-time, non-refundable enrollment fee and KY sales tax on first month's membership fee. Once submitted, you will receive an invoice via email, generally within 24 hours. Your signature on this form and payment of the invoice is your acceptance of the billing contract.
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PLATINUM MEMBERSHIPOur best-value! Monthly membership for adults, teens & kids ages 6 +. Access to all regularly scheduled BJJ classes. Requires auto-draft payments and 6 month contract
$181.00 LEVEL



FIRST RESPONDERS MEMBERSHIP Our Platinum Membership discounted for active duty LEOs, firefighters (full or part time) & emergency medical personnel. Access to all regularly scheduled BJJ classes.
$103.00 LEVEL



MILITARY MEMBERSHIP Our Platinum Membership discounted for veterans & members of the National Guard or Reserve. Access to all regularly scheduled BJJ classes.
$129.50 LEVEL



Total

$0.00
BILLING CONTACT INFORMATION

Please list the information for the responsible billing party.
Name of Billing Contact*

First NameLast Name
Billing Contact Address*

Street Address

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Billing Contact Number*
Billing Contact E-mail*
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Billing Communication Permissions *

Thank you for your interest in NexJen BJJ. We are sorry, but we cannot enroll you at this time. Please contact us at info@nexjenbjj.com for more information.

BILLING AGREEMENT
Please review this section carefully! Submission of this form and payment of your first invoice is your acknowledgement of your acceptance of the NexJen billing and auto draft agreement.
-Platinum membership packages entitle the member to attend any/all regularly scheduled BJJ classes and open mat sessions. Fees for seminars, special events and add-on classes (ex: karate, cardio MMA) are NOT included as part of the membership unless otherwise specified.

-Platinum membership packages require a 6 month contract with scheduled auto draft payments (credit, debit or ACH). The payment method used to pay the initial invoice is the method that will be used to set up your auto draft payments.

-The first month payment will be prorated by the week if 3 weeks or less are left in the month at enrollment. Enrollment fees are NOT prorated and are non-refundable.

-The 6 month contract begins the 1st of the month following the enrollment date. After the initial payment, membership fees are automatically drafted on the 1st of each month. No prior-notification of the charge will be provided unless the date or amount changes, in which case you will receive notice from us at least 10 days prior to the payment being collected.

-Contracts automatically renew unless written notice of termination is received a minimum of 14 days prior to the end of the contract. Otherwise a new 6 month contract will begin. An additional enrollment fee is not charged for auto-renewals with no changes.

-If a membership contract (whether the initial or auto-renewed) is canceled in the 1st-5th month, an early cancellation fee equal to ½ of the remaining contract balance will be due immediately and payment will be auto-drafted from the billing account.

-a $25 fee will be charged for NSF or failed auto draft payments

-To receive a first responder or military discount, the first responder/military member must be the primary membership holder and active student.

-Multi-level discounts apply to members of the same family/household only.

Off contract changes to family membership packages

Adding or dropping members to family membership package can be done if written notice is received a minimum of 14 days prior to the end of the contract. Adds to membership incur a $25 enrollment fee per new member.

For changes to a membership package outside the 14 day period:

Adding member(s) $50 enrollment fee per new member + level cost difference. Resets contract date to new 6 month period.

Dropping member(s) 1/2 of level cost difference for each month remaining on contract. Resets contract date to new 6 month period.
Please verify that you have reviewed and understand the billing agreement above. Submission of this form and payment of your first invoice is your acknowledgement of your acceptance of the NexJen billing agreement.*

Yes, I have reviewed the billing agreement. I understand that monthly payments are required via auto-draft, either with a debit or credit card or by ACH. I understand that final membership is contingent upon my completed background check and that failure to complete a check or an adverse report will result in termination of the enrollment, in which case, enrollment fees paid are non-refundable.
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MEMBERSHIP REQUEST FORM

MEMBERSHIP PLAN SELECTION

BILLING CONTACT INFORMATION

BILLING AGREEMENT

Please review this section carefully! Submission of this form and payment of your first invoice is your acknowledgement of your acceptance of the NexJen billing and auto draft agreement.