QUARTERBACK COMBINE YOUTH REGISTRATION PAGE
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$750.00 / 10 Sessions    QB Has CHOICE to train Sat / Sun or Both
Select Sessions:
SESSION A:    SATURDAYS  10 Sessions   8:00 am - 11:00 am
LOCATION:  TBA
JAN.           10,    17,    24,    31
FEB.            7,    14,    21,    28
MARCH        7   (Double Session  7 on 7)
Location:  Santa Monica College

SESSION B:   SUNDAYS  10 Sessions     2:00 pm -  5:00
LOCATION: TBA
JAN:         11,     18,    25
FEB.:        1,    8,    15,    22
MARCH:    1,    8 (double session)   7 on 7
Location:  Santa Monica College

SESSION A  &  B    Saturdays and Sundays  (See Above: Dates/ Times/ Locations)
$300.00 Discount If Quarterback Trains in A & B
Mandatory Medical Waiver
BACK TO BACK SESSIONS AND
CONTINUOUS REPITITIONS
INCREASES IMPROVEMENT FASTER

If you miss a session in the A
Block,  you can make it up in the B
Sessions (2 max)
SELECT PAYMENT OPTION:    
ATTENTION  ALL  
REQUIRED
FIELDS BELOW MUST BE
COMPLETED
$750.00 Pay in full now                       
$250.00 DEPOSIT (non-refundable)
Balance Due Anytime Before Jan. 1 2015
Athlete Information:
Athletes name:
Athletes School:
Athletes DOB:
Athletes Grade:
Athletes Position:
Athletes Height:
Athletes Weight:
Athletes Insurance Co:
Athletes Insurance Policy No:
Athletes email address:
Athletes phone number:
Athletes Cell:
Referred by:
PARENT INFORMATION REQUIRED
Parent Name:
Parent Cell:
Parents Email Address:
Address:
City:
State:
Zip code:
PAYMENT OPTIONS
Master Card
Visa
American Express
Check  
Credit Card Number:
Expiration date:
CARD  SECURITY CODE:
IF PAYING BY CREDIT
CARD ALL FIELDS MUST
BE COMPLETE!
Name: as appears on card:
Address:
City:
State:
Zip code:
AGREEMENT: This agreement shall be binding upon both parties and or any responsible party. QB Combine accepts credit cards, money orders, checks or
cash.  It is agreed that the Client or responsible party for the Client will carry his own insurance. Parents release, hold harmless and waive any and all
responsibility of the QB Combine/TOPGUN Combine, any and all facilities used, the staff or city in regards to the athlete in any way. This agreement
constitutes the entire understanding between the parties. A waiver of breach of any provisions and acknowledgements of the rules of this agreement shall
not be construed as a continuing waiver of other breaches of the same or other provisions hereof. This agreement shall be governed by the laws of the State
of California.  The total information input on this form from the athlete and the responsible party for the athlete give authorization for the Client named
above to participate in all aspects of the sessions of the QB Combine/ TOP GUN Combine. It is agreed that the client or the responsible party of the client
acknowledges and agrees to all conditions of the Medical Waiver. Photos and video taken of the Combine and athletes are the sole ownership of the
Quarterback Combine which is authorized to use for their web site or promotions.

Submitting online agrees to all conditions. (NO REFUNDS).
By submitting on line, constitutes my signature and authorization to the agreement stated, all provisions and authorization for the Quarterback Combine
to charge the credit card information input for training fees selected. Discounts will be deducted automatically before the credit card information is
processed.
We accept:  MASTER CARD, VISA & American Express
3% - 6% Process Fee
Absolutely
NO REFUNDS at any time on any amount, services, post dated checks, cancellation of services and NO CHARGE BACKS. Post Dated checks issued
validate a confirmed validated "contract'' of services and must be valid in full on the date specified. No refunds due on any service cancellations. All checks
issued (current and post dated) will be governed by the Bad Check Restitution Program. (allowed to be paid back (3) times the amount of the check. Policies
are strict and non-negotiable.Enrollment, Registration and Payment for any training services, combines and events on line submitted or with any coach or
staff manually confirms and validates a full (100%) contract that can not be broken or adjusted at any time. Payee understands, acknowledges and agrees
to all policies. Payee agrees to the time limit period in the Long Term Program (2 year max or when the date on the confirmation ends), weather all
sessions are completed. There will be "no"  carry over for balance of sessions that remain after the final (2) year long term date. Once payment is received
the payee agrees that there are NO REFUNDS for any reason at any time. In the event that the athlete chooses to stop training or cancel for what ever
reasons, it is agreed by the payee to forfeit in full all monies paid and or all monies due and all post dated checks will be honored and paid in full on the
post date specified.
To receive monies applied to any upgrade, upgrades must be made by the 4th session of any plan.

Any monies owed or payment plan owing, if the balances are not paid on the date will result in immediate stoppage of training and full amount will be
due immediate with NO REFUNDS. Risk management rules and policy protects the staff and coaches with a guarantee of payment. All policies apply to
any verbal, written agreement to any coach or staff member in which full authorization to cash checks or charge credit cards will be done immediate.
Any payment late delayed, NSF checks or credit card invalid,  the full amount owed will be collected immediate and may result in the stoppage of training
and all sessions owed will be terminated. Verbal agreements are fully confirmed and valid once the first payment is collected and all parties have read,
acknowledge and agree with The Quarterback Combine policies.

Any attempt for suits/ law suit against any officer, coach, staff member or the Quarterback Training Combine entity itself, parent or responsible
registration party of the quarterback or athlete releases in full liability both personal, revenue, equity and personal assets in which all the above named
are held harmless to any action. Quarterback Combine staff, officers, coaches are not liable for any reason at any time and the parent or responsible
registration party fully releases all the above in which no claims can be made. Attorney fees, court costs and all expenses in the event that any party
pursues with no justification and has agreed to these terms, all costs (said) and expenses will be the full responsibility of the parent or party who
registered the quarterback or athlete.

By submitting On Line, this constitutes and acts as my signature (card holder) for this transaction and all or any other transactions (both verbal or
manual), in which this or any transaction and charges cannot be disputed or charge back. I (card holder) release all rights to any charge backs.
I have read and agree to the above terms:
Mandatory Medical Waiver
© 2014 Quarterback Combine. All rights reserved.
"reps" up in private training which will
only make him better and Game Ready.
See:
THE TALK
See: PRIVATE TRAINING