I, the guardian of above named student(s), consent to his/her participation in activities occurring as a result of enrollment in Northwest Athletics, LLC. I am aware that any activity involving motion or height creates the possibility of serious injury, not excluding paralysis, or even death. I authorize the staff of Northwest Athletics, LLC to provide first aid care within their realm of knowledge and, if necessary, to call an ambulance, for which I will be financially responsible. I further release from liability Northwest Athletics, LLC and its representatives for incidents occurring while participating in activities at or in conjunction with Northwest Athletics, LLC and assume all financial responsibility for such incidents. I understand that it would be in my best interest to provide medical insurance coverage, as I am responsible for all medical expenses.
I represent and warrant that if I am purchasing something or paying for a service from this facility or from other merchants through this facility that (i) any credit card or bank account draft (ACH Draft) information I supply is true and complete, (ii) charges incurred by me will be honored by my credit card company or financial institution, and (iii) I will pay the charges incurred by me at the posted prices, including any applicable taxes, fees, and penalties.
I hereby authorize (if online payment is made or autopay information is provided) this facility to charge my ACH draft, or credit card account. I understand that a 30 day written notice is required to terminate billing and I am responsible for payment whether or not my student attends classes until I notify this facility in writing to drop my student from class(es).
Should I dispute a charge through my financial institution this will constitute a breach of contract possibly resulting in, but not limited to, penalties, additional fees, collection, legal action, and/or termination of any and/or all current and future services.
Checks returned unpaid will be subject to a $30 fee to Northwest Athletics, LLC.