Emergency contact name and phone number: (if same as above, please insert "same"): *
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Membership Start Date: *
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Credit Card Number: *
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Credit Card Expiration Date: *
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CVV: *
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ZIP CODE: *
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Desired Membership Level: *
General Terms (Once you have read and understood each term, please check the box) *
Required
1. As a result of the completion of this agreement, I hereby allow Toros Development School to withdraw the selected amount above every month until I have cancelled and given Toros proper notice PRIOR to billing. *
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2. I agree and understand that it is my responsibility to provide proper notice to Toros PRIOR to my billing cycle if I am wanting to terminate my monthly membership. *
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How did you hear about us? *
If you were referred by another player, please insert their name below. If not applicable, write N/A. *
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If you referred by a coach, please insert their name below. If not applicable, write N/A. *
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Current Club & Team *
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Which 2 days per week is your player looking to attend sessions? *
Signature: (by typing your name below, you are providing us your electronic signature) *
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A copy of your responses will be emailed to the address you provided.