WELCOME TO GRACIE BARRA SOMERSET WEST

MEMBER APPLICATION FORM 2013
WELCOME TO GRACIE BARRA SOMERSET WEST
STUDENT NAME ……………………………………………………………………....
STUDENT ID NO………………………………………………………………………...
STUDENT CELL NO…………………………….……………………………………….
This application is subject to the following conditions:a) Martial Arts are a potentially dangerous activity and although the highest possible training
standards are being followed, accidents and/or injuries might occur.
b) The student herewith accepts all the risks connected to the practising of Brazilian Jiu-jitsu,
and indemnifies with this the instructor/s and/or all controlling bodies and/or persons
connected to GBSW against any claims as a result of an injury and/or other issues that may
occur while practising GBSW
c) The student declares that he/she is in good health and that he/she is not aware of any
condition or health risk that might be a risk in the practise of Brazilian Jiu Jitsu
FEE STRUCTURE (3 Options)
1. Monthly Training Fee R 325.00 per Month payable by Debit Order or
2. 6 months paid in advance R 1 625.00 (1 month free) + Annual joining Fee
3. 12 months paid in advance R 3 250.00 (2 months free) + Annual Joining Fee
TERM
This Agreement shall be in effect for 12 months commencing on the Effective Date.
TERMINATION
The Student may cancel the contract at any time giving 90 days written notice. Fees for the
termination period will be paid irrespective of attendance.
TRAINING DAYS / TIMES
5.15pm - 6.30 pm Tuesday and Thursday & Saturday Mornings 9.30 -11.30
Gracie Barra Somerset West
Head Instructors James McCallum Bradley McCallum
Slow is Smooth Smooth is Fast
BLACK BELT SEMINAR
For those students wishing to make fast track belt progress, There will be a Black Belt Seminar at
the Academy once per month at an additional cost of R 200.00 paid in cash. Prior verbal notice will
be given to verify date and attendance.
WHAT’S NEXT
Prior to the student being accepted the following will be required
1.
2.
3.
4.
Contract returned, signed by all parties
Annual Joining fee R175.00 plus 1 month fee paid upfront R500.00
Debit order form completed
Purchase of Jiu Jitsu GI from GB Somerset West Average Price size dependant R750R1500.00 incl vat
5. Initial fitness test completed
I hereby certify that I have read the agreement carefully and understand fully the contents
thereof. I further agree to abide by the rules and regulations and terms and conditions of
GBSW as laid down.
Member…………………………………………………….…Guradian/Parent…………………………..…………………………
Date… ………………………………………………………….Instructor…………………………………………………………………
Bradley McCallum GB Purple Belt
Gracie Barra Somerset West
Head Instructors James McCallum Bradley McCallum
Slow is Smooth Smooth is Fast