11468 Sorrento Valley Rd. Ste. A-1 San Diego, CA 92121
Registration Fencer’s Name: Last name, First name Parent’s Name: (if fencer is under age 18)
Last name, First name
Primary Phone:
Email:
How did you hear about Team Touché Fencing? (Please indicate source.)
I would like to register for the following: 3 Weapon Group Class (Sparring Practice Included) - Beginner Day of Week 1X/week 2X/week 3X/week Drop in Class
T T T T
TH TH TH TH
SA SA SA SA
Private Lessons + Sparring Practice Individual (20 min.) 1X/week 2X/week 3x/week Family/ Group (1hr., 2-4 ppl.) – Individual
$125/mo. $185/mo. $225/mo. $40/class
$40/ea. $180/mo. $300/mo. $400/mo. $70/ea.
Top Dog: $285/mo. (By Coach’s Invitation) - Competitive T, TH, SA Top Dog Foil* M, W, SA Top Dog Epee* M, W, SA Top Dog Sabre* * Includes Friday Night Sparring Practice, 6pm – 8pm Drop in Class $50/class
Bundled Savings + Sparring Practice 1X1: 1 Group + 1 Private/week 2X1: 2 Group + 1 Private/week TDX1: Top Dog + 1 Private/week TDX1: Top Dog + 2 Private/week
Alpha Dog: $380/mo. (By Coach’s Invitation) – Olympic Track Alpha Dog Foil** Alpha Dog Epee** Alpha Dog Sabre**
M - SA M - SA M - SA
Sparring Practice Monday to Friday 6:30-9:00pm Unlimited Spartak Membership (M, W)
Chivalry School Youth - Nonmember Youth - Member Adult Drop In Adult - Member
** Regimented 6 days/week training
$225 $285 $345 $405
$20/day $80/mo. $80/mo.
F F SUN SUN
$95/mo. $80/mo. $25/ea. $80/mo.
Total Monthly Fees
Billing Authorization We offer convenient automatic billing, simply complete this form. All requested information is required. Billing occurs on the first day of each month. Team Touché Fencing will pass on any fees incurred for insufficient funds transactions and may charge you a late fee of $25 if payment is late for any reason. You may cancel authorization and/or service fees with 30 days notice by emailing
[email protected]. Notification in advance of the first of the month is required to avoid monthly fees.
Card Holder Name
Zip Code
Card Number (Mastercard or Visa ONLY)
Expiration Date / CVC
I authorize Team Touché Fencing to automatically bill this credit card $__________ monthly for fees. I understand that any balance due for repair service fees or equipment purchases received by me and not paid immediately will be charged to this credit card on the first of the next month.
Card Holder Signature
Date
(858) 622-9696
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