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ELITE Automated Clearing House (ACH)
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* Indicates required question
Email
*
Your email
Mobile Phone Number:
*
Your answer
Name on Account:
*
Your answer
Account Routing Number: (must have exactly 9 digits):
*
Your answer
Account Number:
*
Your answer
Account Type
*
Checking
Savings
Required
What is your preferred billing date (Effective Date):
*
1st day of the Month
16th day of the Month
What membership are you enrolling for:
*
Tiny Diamonds Jiu-Jitsu (ages 3 & 4)
Youth Jiu-Jitsu (ages 5 and up)
Adult Jiu-Jitsu
Women's Jiu-Jitsu
Brave Jiu-Jitsu (Brave Membership)
Brave Jiu-Jitsu (Athlete Sponsor)
How many classes per week are you attending (enrolling):
*
1 class/week
2 classes/week
3 classes/week
4 or more classes/week (unlimited training)
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