The auto payment monthly contract will require each participant or parent of a minor to sign below, confirming that they accept and understand that they will be under contract to pay Mad Tiger Academy for services at a reduced monthly cost. Payments will be taken out monthly on the 2 nd of EACH month (unless other date(s) specified) by credit or debit card or checking. All payment information will be kept secure and confidential. Customers are required to provide ONE MONTH notice in writing to stop payments from being charged. A $5.00 Service fee for each returned payment transaction.
I agree and fully understand that I will pay Mad Tiger Academy at a special reduced price for monthly services using an autopayment method. I will be charged by the 2 nd of each month using the financial account that I list below for one month of service at a time for 3 consecutive months After the three month period I will be automatically put on a month to month contract and be required to give one month notice to stop payments. I understand that I will be charged even if I choose not to participate in the program, unless I provide one month notice to cancel the service. I clearly understand that I will notify mad tiger academy if I would like to break my contract one month in advanced in writing. Payments will continue to be processed and no refunds will occur unless notification is given meeting the above criteria. Exceptions can be made as to when payments can be withdrawn from the account each month.
By signing below I agree to the contract and completely understand the information above. Complete each section below.
Sign here:______________________________________________ Date:_____________________
Name of Participant:__________________________________________
Credit Card/ Debit/ Check Number:_______________________________________________________
Name of payment holder:____________________________________________________
Billing Address: ____________________________________________________ Card Type:______________
Expiration date (month /year):__________________________cvv code:____________
Six Contract Effective start and end date: ___________________to _____________________(month/year)
Billing Zipcode: Monthly dues: Receipt email cell #:
If you choose NOT to participate in the autopayment contract option you can still participate in the Mad Tiger Program.
MONTH to MONTH service fees are:
ONE day a week: $70 per month (kids /teens only program) Drop In $15/ $20)
Up to THREE days per week: $90 per month (kids/teens program) $120 (adults program) (Drop In $15/ $20)
UNLIMITED BJJ: $150 per month
MUAY THAI: $80 per month (Drop In $10)
UNLIMITED BJJ and MUAY THAI: $200 per month
INSANITY/BOOT CAMP: $109 per month (Drop In $10)
ADVANCED PAYMENT PLANS:
KIDS BJJ PROGRAM SPECIALS
$459 - 6 Months for 3 days per Week (over $80 savings)
$499 - 6 Months for unlimited training (over $100 savings)
$1000 – 1 year unlimited Jiu Jitsu training ($410 savings)*
ADULTS PROGRAM SPECIALS
Includes (1) 30 minute or hour long private.
$575 - 6 Months Unlimited Jiu Jitsu ($325 savings)
$1000 – 1 year unlimited Jiu Jitsu training ($800 savings)*
$1400 – Unlimited Jiu Jitsu and Muay Thai Training ($1360 savings)
Reminder to all, we do not prorate monthly payments due to illness or vacation. Sorry no exceptions.
Drop in rates will remain at $15 per class and is required before the start of each class. $20 Drop in rate for non-registered participants.
Muay Thai, Yoga, Boot Camp, Insanity and Boxing drop in rates are $10 per class.
All purchases, payments and registration are nonrefundable.
Family rates still apply: $5-$10 off for each additional participant (immediate family members only)
Insufficient funds fee will remain at $25.00 per transaction.
Contract COPY : I agree and fully understand that I will pay Mad Tiger Academy at a special reduced price for monthly services using an auto payment method. I will be charged by the 2 nd
of each month using the financial account that I list below for one month of service at a time for 3 consecutive months, after the three month period I will be automatically put on a month to month contract and be required to give one month notice in writing to stop payments. I understand that I will be charged even if I choose not to participate in the program, unless I provide notice to cancel the service. I clearly understand that I will notify mad tiger academy if I would like to break my contract one month in advanced in writing. Payments will continue to be processed and no refunds will occur unless notification is given meeting the above criteria. Exceptions can be made as to when payments can be withdrawn from the account each month.
.
6 month Start and End date: __________________________to __________________________________(month/year)
Make Checks Payable to: Mad Tiger Academy. $25 fee for all insufficient payments. $20 late fee for all payments after the 5 th
of each month. Plan ahead and request additional time or a payment plan for no additional fee.

$50 Registration Fee Required (includes Patch)
(10 & under) Mon. 4:30-5:30 pm, Tue. 5:00-5:50 pm, Wed. 4:30-5:30pm, Thur. (4-6 yrs.) 4:00-
4:50pm, Thurs. (7-10 yrs.) 5:00-5:50, Sat. 11-12 pm.
: Mon. 5:30-6:30 pm, Wed. 5:30-6:30 pm, Sat.12:00-1:00pm
Mon. & Wed. 6:30-8:00 pm (novice) and 8:00-9:00 pm (advanced), Tue/Thur. 11:00am-
12:30pm, Sat.1:00-2:30 pm
: Tue/Thur. 6:00-7:30 pm
: Fri 6:30-8:30 pm, Sun 4:00-6:00 pm
(
$5 drop ins for other class)
Tue / Thu 7:45-9:15 pm, Sat. 4:00-5:30 pm
Sat: 9:00-10:00 am
Mon/Tue/Wed/Thurs/Fri. 5:00-5:50 am
CHECK CALENDER FOR CURRENT TIMES! ALL CLASSES OPEN FOR ENROLLMENT. *No registration fee required
___________________________________________________________________________________________________________
LAST NAME FIRST NAME BIRTHDATE PROGRAM ENROLLED
___________________________________________________________________________________________________________
HOME ADDRESS APT # CITY ZIP
Make Checks Payable to: Mad Tiger Academy. $25 fee for all insufficient payments. $20 late fee for all payments after the 5 th
of each month. Plan ahead and request additional time or a payment plan for no additional fee.

___________________________________________________________________________________________________________
CELL NUMBER HOME PHONE NUMBER E-MAIL ADDRESS
MEDICAL INSURANCE POLICY # MEDICAL CONDITIONS/ALLERGIES WE SHOULD BE AWARE OF?
____________________________________________________________________________________________________________
EMERGENCY CONTACT PERSON #1 HM # CELL # WRK #
____________________________________________________________________________________________________________
EMERGENCY CONTACT PERSON #2 HM # CELL # WRK #
____________________________________________________________________________________________________________
HOW DID YOU HEAR OF US? Are you in the Military?
Name of adult participant:_________________________________________________
I, despite all reasonable precautions implemented for safety, am fully aware of and acknowledge the risks, including the risks of catastrophic injury, paralysis and even death, as well as other damages and losses associated with participation in the programs or activities in regards to MTA Brazilian Jiu-Jitsu, Muay Thai, Yoga, Boot Camp, Boxing, Mat play and any other programs that are held at Mad Tiger Academy. If in an emergency medical assistance is needed, emergency services will be called and the signor will be taken to the nearest medical facility and may be given an examination/treatment that is deemed necessary by the medical facility. All costs of any medical evaluation and treatment will be the responsibility of the participant. I knowingly and willingly assume all such risks. Consequently, I hereby for myself, heirs, executors and administrators, do waive and release any and all rights and claims against the owner, operator, coaches and other members of IT’S ALL GOO DBA Mad Tiger from personal injury or accident of any sort or nature suffered by me, the undersigned, by reason of participation or membership in classes, lessons or any programs of ITS
ALL GOO DBA Mad Tiger BJJ. Any and all legal fees will be the participants’ responsibility including all fees assessed to Mad Tiger
Academy and its affiliates.
________________________________________________________________________
Participant signature (if over 18) Date:
Everyone entering the dojo is required to remove their shoes. Cleanliness is vital to a safe dojo. Please wash gis after every practice.
Keep hands and feet clean prior to the class. Nails should be clean and short. Do not walk around outside without shoes. If you notice unusual rashes seek medical attention right away and notify Mad Tiger Academy. Do not train until it has been authorized by the physician. Do not feel offended if an instructor requests skin conditions be addressed before returning to the mats. Cover all open wounds prior to class. If sick please stay home and get well and make up missed practice when you are feeling better. Classes are monitored monthly not weekly. Be kind to your team mates, no cliques, negative comments or teasing are accepted on or off the mats.
If you notice negative behavior let the instructor know and model appropriate behavior. Bowing when getting on and leaving the mats shows respect to the arts and the mats. Sign into class before getting onto the mats. Pictures of participants and family members may be taken inside the dojo during class or social events for updated brochures or social media posts. Please check here if this will be an issue (_)
___________________________________________________________________________________________________________
Child LAST NAME FIRST NAME BIRTHDATE PROGRAM ENROLLED
____________________________________________________________________________________________________________
Child #2 LAST NAME FIRST NAME BIRTHDATE PROGRAM ENROLLED
Make Checks Payable to: Mad Tiger Academy. $25 fee for all insufficient payments. $20 late fee for all payments after the 5 th
of each month. Plan ahead and request additional time or a payment plan for no additional fee.

____________________________________________________________________________________________________________
FATHER/LEGAL GUARDIAN PHONE NUMBER(S) Email address
____________________________________________________________________________________________________________
MOTHER /LEGAL GUARDIAN PHONE NUMBER(S) Email address
____________________________________________________________________________________________________________
HOME ADDRESS APT # CITY ZIP HOME PHONE #
____________________________________________________________________________________________________________
INSURANCE COMPANY POLICY # CONDITIONS/ALLERGIES WE SHOULD BE AWARE OF?
___________________________________________________________________________________________________________
HOW DID YOU HEAR OF US? MILITARY?
AUTHORIZED TO PICK UP AND EMERGENCY CONTACTS –This person may be called in case of an emergency and are authorized to pick up my child from the site:
_______________________________________________________________________________________________________
Name Relationship Contact #(s)
I hereby agree that, if ITS ALL GOO DBA Mad Tiger BJJ staff is unable to contact me or one of the persons listed as an emergency contact, I hereby consent that if my child exhibits signs of illness or injury, that at the discretion of ITS ALL GOO DBA Mad Tiger, my child may be taken to the nearest medical facility and be given an examination/treatment that is deemed necessary by the medical facility. All costs of the medical evaluation and treatment will be the responsibility of the parent or guardian of the child. Parent or
Guardian Signature: ______________________________________________________________________
Discipline is used to insure the safety and well-being of all program participants. All children are expected to respect themselves, others and their property. If a child is not following the rules and the guidelines of ITS ALL GOO DBA Mad Tiger, then the child will be given a time out from the activity at the instructor’s discretion. A child with continued behavior problems (as a last resort) will have their parent’s notified for the purpose of removing the child from the program. If the child is removed from the program in the middle of a prepaid month, the payment will not be prorated and/or returned. Everyone entering the dojo is required to remove their shoes.
Cleanliness is vital to a safe dojo. Please wash kimonos after every practice. Keep hands and feet clean prior to the class. Nails should be clean and short. Do not walk around outside without shoes. If you notice unusual rashes seek medical attention right away and notify Mad Tiger Academy. Do not train until it has been authorized by the physician. Do not feel offended if an instructor requests skin conditions be addressed before returning to the mats. Cover all open wounds prior to class. If sick please stay home and get well and make up missed practice when feeling better. Classes are monitored monthly not weekly. Be kind to your team mats, no cliques, negative comments or teasing are accepted on or off the mats. If you notice negative behavior let the instructor know and model appropriate behavior. Bowing when getting on and leaving the mats shows respect to the arts and the mats. Sign in before getting onto the mats. Pictures of participants and family members may be taken inside the dojo during class or social events for updated brochures or social media posts. Please check here if this will be an issue (_)
I, the minor’s parent and /or legal guardian, understand the nature of these activities and my child’s experience and capabilities and believe the minor to be qualified, in good health and in proper physical condition to participate in such activities. I, am fully aware of and acknowledge the risks, including the risks of catastrophic injury, paralysis and even death, as well as other damages and losses associated with participation in the programs or activities in spite of all precautionary measures taken. I knowingly and willingly assume all such risks. Consequently, I hereby for myself, heirs, executors and administrators, do waive and release any and all rights and claims against the owner, operator, coaches and other members of ITS ALL GOO DBA Mad Tiger from personal injury or accident of any sort or nature suffered by my child, by reason of participation or membership in classes, lessons or any programs of
ITS ALL GOO DBA Mad Tiger. Any and all legal fees and medical expenses will be the responsibility of the participant’s legal guardian, including all fees assessed to Mad Tiger Academy and its affiliates.
___________________________________________________________________________________________________________
Print Guardian Name: Guardian Signature:
___________________________________________________________________________________________________________
Print Guardian Name: Guardian Signature:
Make Checks Payable to: Mad Tiger Academy. $25 fee for all insufficient payments. $20 late fee for all payments after the 5 th
of each month. Plan ahead and request additional time or a payment plan for no additional fee.