Membership Terms

$100 Registration: Includes administrative setup cost, uniform (includes all color belt upgrades), adult student handbook, and loaner weapons.  

Monthly Term of Instruction: Continuous month-to month auto-payment until member provides 30 day written notice of cancellation/suspension.  
A cancellation/suspension notice will be processed within 30 days of notification.  

12-Month Term of Instruction:  The member agrees to continuous monthly auto-payment for 12 consecutive months, and thereafter agrees that
the membership will convert to a Monthly Term of Instruction at the same price, unless the member renews the 12-month term of instruction.
Advanced Payment:  Covers 6 or 12 months in one payment up front.  Significant savings can be had using this approach.

Method of Payment:  All monthly payments are made using automatic electronic transfer from the member's credit or debit card.  The member
may decides between the 1st or 15th of the month for monthly payments to be made.
Term of Instruction
12 Month
Advanced Payment
Registration Waived
6 Months = $660
12 months = $1220
6 Months = $600
12 Months = $1100

I hereby release, waive, discharge, and covenant not to sue River City Aikido, Brian Hill, guest instructors, consultants and others who give
recommendations, directions or instructions, all for the purpose herein referred to as “Releasee”…From all liability to the undersigned, my/our
personal representatives, assigns, executors, heirs and next to kin from any and all claims, demands, losses or damages and any claims or
demands therefore on account of any injury, including but not limited to the death of the participant or damage to property, arising out of or relating
to the events(s) caused, alleged to be caused, in whole or in part by the negligence of the Releasee or otherwise. Each of the undersigned further
expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law
of the Commonwealth of Virginia and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal
force and effect.

I fully acknowledge that I am applying for instruction in a martial art involving strenuous exercise and personal body contact, and there are risks
associated with participation in martial arts activities that could result in bodily injury.  I acknowledge fully that these risks may be caused by the
action, inaction or negligence of the participant; or the action, inaction or negligence of others, including, but not limited to, the Releasee.  The
student, parent and/or legal guardian should, prior to instruction inspect the facilities to be used, and if anything is believed unsafe, should not
participate.  Each of the undersigned also expressly acknowledges that injuries received may be compounded or increased by negligent rescue
operations or procedures of the releasees.   I/WE accept and assume the risks and responsibility for the losses and/or damages following such
injury, disability, paralysis or death, however caused, and whether caused in whole or in part by the negligence of the Releasee named below.

I agree that the health, welfare, and safety of all students, members, and instructors of the school are of paramount importance.  I certify that there
is no medical reason to preclude me from martial arts training.  I certify that, other than as stated above, I do not have a communicable,
contagious, or other health condition that poses a medically recognized or dangerous risk of harm to other students, members or instructors of
the school.  I agree to provide the school with written notice if my contact information changes.  I permit the school to send me communications at
the above addresses.  I permit the school to use any photos in which I may appear.    I agree to follow explicitly all instructions given by the
instructors during the course of my instruction.  I understand that training is a privilege and that the school may refuse to provide instruction to any
person at any time.

I have chosen the above Term of Instruction and monthly amount/advanced payment, and I agree to the above financial commitment and to the
membership policies outlined above.  I understand there may be occasional class cancellations due to emergencies, illness, schedule conflicts
with our facility, or in the event of severe weather (weather closings are in sync with local schools).  These infrequent occasions are factored into
overall membership costs, and every effort will be made to communicate class cancellation in a timely manner.  No refunds or makeup classes
will be given in such instances. Should the member move out of the area, or sustain a physical injury that prevents the member from training,
release from the term of instruction will be honored.  At the end of the term of instruction, the member has the option to renew at the same price
as long at the renewal is for the same term of instruction.  If the member does not renew at the same level, and/or discontinues, future
membership will reflect current prices at that time.

I understand that dojo membership is managed through Electronic Funds Transfer (EFT).  I authorize payments to occur between my bank
account/credit card and the dojo bank account ongoing for the term stated in the agreement.  If an electronic payment fails (due to insufficient
funds or expired credit card information), I authorize River City Aikido/Brian Hill to collect a returned item fee of $25.00 per item.

As a duly authorized signer on the credit card or financial institution account identified below, I authorize River City Aikido/Brian Hill to perform
electronic funds transfers or credits, as well as to make changes in the above amounts and dates with written permission by email.  This
authorization is to remain in full force and effect until River City Aikido/Brian Hill has received 30 days written notification of desire to suspend or
terminate  (Monthly Members) or until the term of the authorization expires (Yearly/Monthly Members).  Written notification may be sent to the
following address:  3421 Hawthorne Ave, Richmond, VA 23222.

I have read the waiver of liability, financial and membership agreement, fully understand its terms, and have signed it voluntarily without any
inducement or guarantee being made to me, and intend my signature to be a complete and unconditional release of all liability.  I fully understand
the River City Aikido Code of Conduct and I agree to abide by these expectations to the best of my ability, with the understanding that a willful
failure to do so may result in dismissal.
Applicant Name:
Cell Phone:
Minor Parent's Names if Applicable:
Email Address:
Emergency Contact Number:
Emergency Contact Name:
How did you hear about the dojo?
Please describe any pre-existing injuries or medical conditions:
Describe any special learning needs we can accomodate:
What are your goals for studying aikido?
Please Choose a Term of Instruction:
Adult 6-Month Advanced Payment: $660
Adult Monthly: $120 per month
Adult 12-Month Advanced Payment: $1220
Adult Yearly: $110 per month
Child 6-Month Advanced Payment: $600
Child Monthly: $110 per month
Child 12-Month Advanced Payment: $1100
Child Yearly: $ 100 per month
Please check which day of the month
you prefer payments to be made:
15th of the month
1st of the month
Please Provide Payment Information:
Credit/Debit Card Number:
Zip Code:
Expiration Date:
Security Code:
By checking this box I acknowledge I have read and agree to the terms of membership, the membership waiver, and the financial
agreement I have chosen above.  Further my entered name and date below serves as my signature acknowledging my
understanding and agreement to the terms delineated in the membership application.
Full Name Indicating Signature and Date: