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303 E. Church Road | 2nd & 3rd Floors | King of Prussia, PA 19406 | 610.279.1229 | www.precisionjj.com

 

 

CANCELLATION NOTICE

(Must be received 30 days prior to scheduled payment date)

PRECISION JIU-JITSU & TRAINING CENTER #2431

 

Send To: ELECTRONIC BILLING

PO Box 5125 | Timonium, Maryland 21094 | 410.252.9206

 

I hereby request that my membership to Precision Jiu-Jitsu & Training Center be CANCELLED. This will serve as my 30 day written notice and I agree that my FINAL ACH payment will be the on the NEXT 1st or 15th AFTER 30 DAYS from today's date: April 24, 2024.

I Agree

I understand that this cancellation does not release me from any other contract obligation I may have with Precision Training Center. I also understand that I will be subject to current program rates and registration fees if I choose to re-enroll at Precision Jiu-Jitsu & Training Center at any time after this cancellation.

NOTE: PLEASE CANCEL USING THE SAME NAME THAT IS ON THE BILLING FORM!

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Reason for Cancellation?

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First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Reason for Cancellation?

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Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Reason for Cancellation?

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Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Reason for Cancellation?

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Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Reason for Cancellation?

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Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Reason for Cancellation?

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Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Reason for Cancellation?

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Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Reason for Cancellation?

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Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Reason for Cancellation?

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Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Reason for Cancellation?

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Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Reason for Cancellation?

Click to customize text box label
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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