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Athlete Information:
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If a session is missed, it is agreed
that (the missed session)will count
as a session).
You may enroll the athlete in (2)
(A&B) Block Sessions.
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Athletes name:
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Athletes School:
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Athletes DOB:
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Athletes Grade:
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Athletes Position:
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Athletes Height:
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Athletes Weight:
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Athletes Insurance Co:
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Athletes Insurance Policy No:
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Athletes email address:
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Athletes phone number:
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Athletes Cell:
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Referred by:
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Select SESSIONS:
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PARENT INFORMATION
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Parent Name:
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Parent Cell:
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Parents Email Address:
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Address:
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City:
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State:
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Zip code:
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PAYMENT OPTIONS
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Master Card
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Visa
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American Express
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Check
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Credit Card Number:
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Expiration date:
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CARD SECURITY CODE:
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Name: as appears on card:
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Address:
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City:
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State:
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Zip code:
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AGREEMENT: This agreement shall be binding upon both parties and or any responsible party. QB Combine
accepts credit cards, money orders, checks or cash. It is agreed that the Client or responsible party for the
Client will carry his own insurance. Parents release, hold harmless and waive any and all responsibility of the
QB Combine/TOPGUN Combine, any and all facilities used, the staff or city in regards to the athlete in any
way. This agreement constitutes the entire understanding between the parties. A waiver of breach of any
provisions and acknowledgements of the rules of this agreement shall not be construed as a continuing waiver
of other breaches of the same or other provisions hereof. This agreement shall be governed by the laws of the
State of California. The total information input on this form from the athlete and the responsible party for the
athlete give authorization for the Client named above to participate in all aspects of the sessions of the QB
Combine/ TOP GUN Combine. It is agreed that the client or the responsible party of the client acknowledges
and agrees to all conditions of the Medical Waiver. Photos and video taken of the Combine and athletes are
the sole ownership of the Quarterback Combine which is authorized to use for their web site or promotions.
Submitting online agrees to all conditions. (NO REFUNDS).
By submitting on line, constitutes my signature and authorization to the agreement stated, all provisions and
authorization for the Quarterback Combine to charge the credit card information input for training fees
selected. Discounts will be deducted automatically before the credit card information is processed.
We accept: MASTER CARD, VISA & American Express
3% - 6% Process Fee
Absolutely NO REFUNDS at any time on any amount, services, post dated checks, cancellation of services and
NO CHARGE BACKS. Post Dated checks issued validate a confirmed validated "contract'' of services and must
be valid in full on the date specified. No refunds due on any service cancellations. All checks issued (current
and post dated) will be governed by the Bad Check Restitution Program. (allowed to be paid back (3) times
the amount of the check. Policies are strict and non-negotiable.Enrollment, Registration and Payment for any
training services, combines and events on line submitted or with any coach or staff manually confirms and
validates a full (100%) contract that can not be broken or adjusted at any time. Payee understands,
acknowledges and agrees to all policies. Payee agrees to the time limit period in the Long Term Program (2
year max or when the date on the confirmation ends), weather all sessions are completed. There will be "no"
carry over for balance of sessions that remain after the final (2) year long term date. Once payment is
received the payee agrees that there are NO REFUNDS for any reason at any time. In the event that the
athlete chooses to stop training or cancel for what ever reasons, it is agreed by the payee to forfeit in full all
monies paid and or all monies due and all post dated checks will be honored and paid in full on the post date
specified.
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Mandatory Medical Waiver
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I have read and agree to the above terms:
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© 2008 Quarterback Combine. All rights reserved. |
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