Toowong Sign Up Parent's Name (if under 18) Student's First Name Student's Last Name Email Address Phone Number Postal Address Student's Date of Birth Number of Classes Per Week select membership option30 minute class x 1 ($17/wk)30 minute class x 2 ($31/wk)45 minute class x 1 ($18/wk)45 minute class x 2 ($33/wk)60 minute class x 1 ($19/wk)60 minute class x 2 ($35/wk)60 Minute Class x 1 and 45 minute Class x 1 ($34/wk)Unlimited Kickboxing/BJJ ($37.5/wk)Unlimited All Styles ($47.5/wk) Uniform Type (to be debited in the next 3 business days) select uniform optionGrey Kickboxing Shirt/Singlet ($35)White Japanese Jujitsu Gi ($65)White Japanese Jujitsu Gi and Grey Training Shirt ($100)Blue BJJ Gi ($125)I already have a uniform Additional Family Members NoYes Second Child's First and Last Name Second Child's Membership Type select membership optionselect membership option30 minute class x 1 ($17/wk)30 minute class x 2 ($31/wk)*45 minute class x 1 ($18/wk)45 minute class x 2 ($33/wk)*60 minute class x 1 ($19/wk)60 minute class x 2 ($35/wk)*60 Minute Class x 1 and 45 minute Class x 1 ($34/wk)*Unlimited Kickboxing/BJJ ($37.5/wk)Unlimited All Styles ($45/wk) Second Family Member Discount Memberships marked with a * are eligible for a second family member discount of $1/lesson if the 1st child is on 2 lessons per week or unlimited. This will be automatically applied if you are elligible Second Child's Uniform (to be debited in the next 3 business days) select uniform optionGrey Kickboxing Shirt/Singlet ($35)White Japanese Jujitsu Gi ($65)White Japanese Jujitsu Gi and Grey Training Shirt ($100)Blue BJJ Gi ($125)I already have a uniform Second Child's Date of Birth Do you have a 3rd family member to sign up? NoYes Third Child's First and Last Name Third Child's Membership Type select membership option30 minute class x 1 ($17/wk)60 minute class x 1 ($19/wk) Third Child's Uniform (to be debited in the next 3 business days) select uniform optionGrey Kickboxing Shirt/Singlet ($35)White Japanese Jujitsu Gi ($65)White Japanese Jujitsu Gi and Grey Training Shirt ($100)Blue BJJ Gi ($125)I already have a uniform Third Child's Date of Birth Please note the 3rd child is exempt from the joining fee of $59 ------------------------------------------------------------------------- Credit Card Number (please note we do not accept American Express) Expiry Month MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Expiry Year Year202420252026202720282029203020312032203320342035 (Optional) Is there anything else we should know or you would like to ask? (Please include the use of any vouchers here. For Fairplay vouchers please put the voucher number in this section) I give my permission for the card provided to be debited from now until I provide written notice via email. My card will be debited in week 2, 4, 6, 8 and 10 of each school term and the second week of the school holidays on the Tuesday of that week. During the Christmas school holidays we are closed for the week of and week after Christmas but are open all other weeks and debits will occur every 2 weeks except the 2 weeks we are closed. A pro-rata fee of the cost of any lessons between now and the next debit date will be applied at the same time as the uniform costs if applicable. I understand that a joining fee of $59 will be debited from the nominated account in the next 3 business days and annual fee of $10 is charged on the 1st of March each year thereafter Terms and Conditions 1. Introduction This document, the āAgreementā, relates to your authority to Martial Arts Queensland to directly debit your nominated bank account or credit card for any instalments or fees due by you under the terms and conditions of this Agreement and DDR attached. These terms are stated below. 2. Parties to Agreement The āMAQLD Centreā means the Martial Arts Queensland Centre named overleaf. The āCustomerā means the person signing this Agreement. āMAQLD HOā is Martial Arts Queensland Head Office, Ph: 1300 766 634, Email: info@maqld.com. All queries and comments about the Services provided under this Agreement should be directed to the MAQLD Centre. All queries and comments about the direct debit billing service should be directed to MAQLD HO. The Customer acknowledges that MAQLD HO has been engaged by the MAQLD Centre to collect the fees due under this Agreement if paying by way of direct debit, and also acknowledges that all rights of the MAQLD Centre under this Agreement are able to be enforced by MAQLD HO as if it were the MAQLD Centre without any involvement on the part of the MAQLD Centre or the consent of the Customer. 3. Comfort Guarantee The Customer is allowed thirty days to change his/her mind after signing this Agreement. If for any reason within the thirty day cooling off period the Customer is not comfortable with the program, the Customer may cancel and receive a complete refund for any money paid for the program and any product returned unused with packaging intact ā no questions asked. The Customer must inform the MAQLD HO in writing. The written notice and all material must be received by the MAQLD HO, not later than close of business on the thirtieth day from the date of this Agreement. 4. Payments The Customer agrees to pay the Instalment amount fortnightly until this Agreement is terminated in accordance with either clause 5 or 14 below. If there are payments owing for any reason at termination, the Customer authorises MAQLD HO to debit the outstanding balance in order to bring the account up to date. 5. Termination of Agreement This clause is subject to clause 12, 14 and 15 of this Agreement. If the box on the front of this Agreement requesting termination at the minimum term is checked then this Agreement will automatically terminate after the minimum term and all Instalments and payments due must be paid in full. Otherwise this Agreement will continue indefinitely until the Customer provides 14 days written notice to the MAQLD HO to terminate the agreement. All payments falling due in the notice period must still be paid in full. The Agreement continues until the Customer has received written confirmation of its termination. Cancellations cannot be backdated. All requests to cancel this agreement must first be made to the MAQLD Centre. Early cancellation of a minimum term program is possible only within the thirty day cooling off period as described in clause 3 above, or if provided in person at the MAQLD Centre on the production of: ā¢ a doctorās certificate detailing an injury or illness that totally prevents future participation; or ā¢ proof of relocation to a new home more than 30km from any MAQLD Centre; and ā¢ a completed Resignation Form giving 14 days notice; and ā¢ payment of an early cancellation fee of $195. After the 14-day notice period is over, no further payment will be deducted from the Customerās account. It is the Customerās responsibility to check their account. 6. Reversal & Dishonour Fee The customer accepts that payments presented against accounts with insufficient funds will be automatically re processed prior to the next installment due date. Payments still unsuccessful by this time will be processed with the next installment on that due date. In addition, a non-honour fee of $10 will be charged to the payer. 7. Program Fee The Customer agrees to pay the start-up fees ā initial instalment set out overleaf, and if paying by Direct Debit, the Instalment amount shown overleaf. Those fees include the set tuition at the MAQLD Centre for the period nominated. Fees for any period are payable whether or not the Services provided by the MAQLD Centre are used. 8. Services The MAQLD Centre reserves the right to add, change or delete Services, amenities and facilities as reasonably necessary. 9. Privacy A Customerās āpersonal informationā (as that term is defined in the Privacy Act 1988 (Cth)) will only be used by MAQLD HO and the MAQLD Centre to provide the Customer with the Services contemplated by this Agreement and any directly related products/services from time to time.. 10. Health Status The Customer warrants the truth and completeness of his/her health disclosure to the MAQLD Centre and undertakes to update it promptly with any changes or developments. The Customer authorises the MAQLD Centre to communicate directly with his/her physician. However the Customer acknowledges that no staff at the MAQLD Centre are medically trained or qualified, and that the Customer is responsible for monitoring his/her own medical condition and obtaining medical advice as to participation in the programs provided by the MAQLD Centre. 11. Liability To the extent permitted by law, both the MAQLD Centre and MAQLD HO hereby exclude any liability of MAQLD HO and/or the MAQLD Centre to the Customer in agreement, tort, statute or in any other way for any injury, damage or loss of any kind whatsoever (including, without limitation, any liability for direct, indirect, special or consequential loss or damage), sustained by the Customer and/or any other person, or for any costs, charges or expenses incurred by the Customer, arising from or in connection with this Agreement and/or the Services/products provided by MAQLD HO and/or the MAQLD Centre, and/or any act or omissions of MAQLD HO and/or the MAQLD Centre. 12. Credit/Debit Reporting Agencies The Customer authorises MAQLD HO to notify any debt collection/credit reporting agency upon default by the Customer, of any obligation under this Agreement. Should the Customer default, then at MAQLD HOā sole discretion, it may terminate the Agreement by writing to the Customer and providing them fourteen days notice from the date of the letter. The outstanding balance for the remainder of the minimum term and payments including any current arrears will then become due in full. In addition MAQLD HO will add $50 costs to the outstanding debt for dealing with the defaulting Member. The Customer authorises MAQLD HO to add an amount of 25% of the outstanding balance for the remainder of the minimum term or payments including any current arrears when first referred to the agency, as a reasonable estimate of the costs incurred by MAQLD HO in collection of the outstanding debt. 13. Provision of Services Change of location or ownership or the name of the MAQLD Centre does not release the Customer from his/her responsibilities under the terms and conditions of this Agreement. 14. Increase in Fees If the Agreement continues after the minimum term under clause 3, MAQLD HO and/or the MAQLD Centre will send 30 days written notice to the Customerās last known address to increase the program and membership fees and the Instalment if the Customer is paying by Direct Debit. If the Customer wishes to terminate this Agreement as a result of the increase in the fees and Instalment, the termination provisions (Clause 5) above will apply. If the Customer does not notify the MAQLD HO of his/her intention to terminate this Agreement within the 30 day period, then this Agreement will remain in force and the increase in the fees and instalment will be deemed to be accepted by the Customer. 15. Up-Front payment If the Customer chooses the Up-front Payment option, there is no cancellation or refund (except within the 30-day cooling off period) for any reason including, for example, non-use, moving, change of mind or employment, too busy, health or personal problems. Renewals of the Agreement will be at the then current fee rates. Up Front Payment memberships may be suspended for a minimum period of 2 weeks, in units of a week, to a maximum of 6 weeks in total within each 12 month period. The suspended weeks will be added to the end of the term. Payment for the Up-Front payment option is made in full at the commencement of this option, directly to the MAQLD Centre. To suspend an Up-Front Payment membership, the customer should apply at the MAQLD HO at least 3 days prior to suspension. 16. Written Agreement The Customer warrants that no one has made any representations or promises (oral or written) to induce his/her entry into this agreement, and that no agreements or understandings with the MAQLD Centre and/or MAQLD HO apply that are not set out in this Agreement. 17. Severance If any provision of this Agreement is invalid, illegal or unenforceable in any respect, the validity, legality and enforceability of the remaining provisions will not be affected and such invalid, illegal or unenforceable provision is to be severed from this Agreement. 18. Membership āOn Holdā (suspended) Memberships may be suspended for a minimum period of 2 weeks, in units of a week, to a maximum of 6 weeks in total within each 12 month period.. The Customerās installment payments must be current and up to date. Applications to suspend this Agreement must be submitted in writing to the MAQLD HO prior to the student/s absence (forms for this are available from the MAQLD Centre). The suspended period will be added to the previous completion date of the Agreement or if on a continuous agreement, payments will be adjusted accordingly with the next payment date. 19. Photo, Video, Audio Release The Customer agrees that MAQLD may take photographs and may take video and audio material or studentās classes and schools events, and that these materials may be used for display, promotion and/or advertising, or sold for profit, and the student hereby waives any compensation to which they may otherwise be entitled for appearing in such materials. Terms and conditions of the Martial Arts Queensland Head Office Direct Debit Request (DDR) Service Agreement 1. Initial Terms MAQLD HO will debit your nominated account for the amounts and at the frequency of payments as agreed between us on the Martial Arts Queensland DDR Agreement signed and accepted by you. 2. Change of Terms In the unlikely event that the initial terms are to change, they can only do so in accordance with your Agreement and we must give you at least 14 days notice of the changes including if applicable the new amount, new frequency and next debit date. 3. Deferring or stopping a payment Should you wish to defer a payment to another date you must contact MAQLD HO before the date of that payment to request the deferment. Deferments are entirely at the discretion of MAQLD HO and will depend on the length of deferment, the current state of your account and your past history. You may request us to stop an individual payment however you will still be liable to make this payment by some other method or your account will become overdue. 4. Altering the Schedule Should you wish to alter the payment frequency or Day to Debit contact MAQLD HO and at our discretion in most instances we will be able to make the changes you require. There may be a fee charged for this service. Any changes made will not affect the total amount you would otherwise have paid over the minimum term of your Agreement. 5. Suspending the Payments Suspension of payments may be possible under the terms of your Agreement. Payments may be suspended for a minimum of 2 weeks at a time so long as the total time suspended within the minimum term does not exceed 6 weeks. In order to suspend payments you should contact MAQLD HO at least 3 days prior to the date of the first suspended payment. Any time spent on suspension will be added onto the minimum term of the Agreement so that the sum of the instalments payable for the minimum term or number of payments shall still be payable regardless of any suspension or suspension charges made. 6. Cancelling the Payments You can cancel this Direct Debit Request Authority by requesting this of MAQLD HO or your bank. Cancellation of the authority to debit your account will not terminate this agreement or remove your liability to make the payments you have agreed to. 7. Disputes If you dispute any debit payment, you must notify MAQLD HO immediately. MAQLD HO will respond to your dispute within 7 working days and will immediately refund the amount of the debit if we are not able to substantiate the reason for it. If you do not receive a satisfactory response from us to your dispute contact your financial institution who will respond to you with an answer to your claim within 5 business days if your claim is lodged within 12 months of the disputed drawing, or within 30 business days if your claim is lodged after 12 months from the disputed drawing. 8. Non Working Days When the day to debit falls on a weekend or public holiday the debit will be initiated on the next working day. 9. Dishonoured Payments It is your responsibility to ensure that on the due date clear funds are available in your nominated account to meet the direct debit payment. Should your payment be dishonoured MAQLD HO will debit you an additional $10 with your next payment and may, if we have not received instructions to the contrary from you, debit both the current due payment and the now overdue payment(s) on the same day. MAQLD HO may debit other fees or costs involved with debt collection in accordance with the terms and conditions of the Agreement. 10. Enquiries Direct all enquiries to us, rather than your financial institution, and these should be made at least 1 working day prior to the next scheduled debit date. 11. Your other Responsibilities In addition to those already mentioned, you are responsible for ensuring that your nominated account is able to accept direct debits. If it is not, it is your responsibility to provide MAQLD HO with a new account number. I have read and agree to the terms and conditions above