JotForm

Biweekly Payments

Electronic Debit

Based on the information entered your biweekly payments are as follows.

$82.31 /Biweekly on these dates*

October 2017	6, 20
November 2017	3, 17
December 2017	1, 15, 29
January 2018	12, 26
February 2018	9, 23
March 2018	9, 23
April 2018	6, 20
May 2018	4, 18
June 2018	1, 15, 29
July 2018	13, 27
August 2018	10, 24
September 2018	7, 21

*Eurostar Academy does offer a 10% sibling discount provded to the youngest player(s) registering in a family. The oldest player fees remain as regular fees. The upcoming Annual fee does not reflect this discount. The total 10% discount is reflected in the biweekly payments only.

Based on the information entered your biweekly payments are as follows.

$86.35 /Biweekly on these dates*

October 2017	6, 20
November 2017	3, 17
December 2017	1, 15, 29
January 2018	12, 26
February 2018	9, 23
March 2018	9, 23
April 2018	6, 20
May 2018	4, 18
June 2018	1, 15, 29
July 2018	13, 27
August 2018	10, 24
September 2018	7, 21

Use the banking information from last year? *

No I need to enter or update the information Yes use the information on file
Institution # *
typically 3-5 numbers
Transit # *
Typically 3-4 numbers
Bank Account # *
Typically 6-10 numbers
PAYOR’S AUTHORIZATION FOR PRE-AUTHORIZED DEBITS (PADS)

1. Authorization to Debit Account. I hereby authorize Eurostar Academy Inc to issue pre-authorized debits drawn on the bank account (the “Account”) added to my Eurostar Academy Inc Account for my personal or business use. Such pre-authorized debits are also referred to as “PADs”. Eurostar Academy Inc may issue PADs sporadically in a dollar amount that I indicate, up to a maximum of $4,000 CAD. Eurostar Academy Inc may issue PADs in the amounts and with the frequency that I authorize from time to time based on my agreement with Eurostar Academy Inc and/or certain merchants. I acknowledge that to add an Account to my Eurostar Academy Inc Account for PADs.

2. Cancellation. I understand that I may cancel this authorization for future transactions at any time by removing the Account from my Eurostar Academy Inc Account through contacting Eurostar Academy management. I understand that removing the Account from the Eurostar Academy Inc system does not cancel pending transfers that I have already initiated and authorized.

3. Waiver of Pre-Notification Period. I expressly waive the right to receive written notice from Eurostar Academy Inc of (a) the payment amount to be debited from the Account before the payment date of any PAD (including any variable amount or sporadic PADs) drawn on the Account or (b) of any change of Payment Date or amount of any PAD.

4. Confirmation Period. Eurostar Academy Inc agrees to provide written confirmation of this authorization at least three (3) days before the first PAD is debited from the Account. I acknowledge that this written confirmation can be provided via email.

5. Sporadic PADs. Eurostar Academy Inc is required to obtain authorization from me for each sporadic PAD. I acknowledge that to subsequently authorize sporadic PADs I must confirm my identity by entering a valid Eurostar Academy Inc user ID and password at login or by through another reasonable method. This shall constitute valid authorization for my financial institution to debit the Account.

6. Recourse. I have certain recourse rights if any PAD does not comply with this authorization. For example, I have the right to receive reimbursement for any PAD that is not authorized or is not consistent with this authorization. To obtain more information on my recourse rights, I may contact my financial institution or visit www.cdnpay.ca.

7. Validation by Financial Institution. I acknowledge that my financial institution is not required to verify that a PAD has been issued in accordance with the terms of this authorization.

8. Contract for Goods and Services. Revocation of this authorization does not terminate any contract for goods or services that exists between me and any Eurostar Academy Inc merchant or between me and Eurostar Academy Inc. This authorization applies only to the method of payment and does not otherwise have any bearing on the related contract for goods or services.

9. Eurostar Academy Inc’s Payment Service Provider. I acknowledge that TD Banking Financial Group, TDBFG (“TD Bank”), acts as the Eurostar Academy Inc’s payment processing representative for the transactions contemplated by this authorization. I agree that the information contained in this authorization may be disclosed to TD Bank as required to complete any PAD transaction. I acknowledge that this authorization is provided for the benefit of Eurostar Academy Inc and is provided in consideration of my financial institution agreeing to process debits against my Account in accordance with the Rules of the Canadian Payments Association.

10. Rights of Dispute. I may dispute a PAD only under the following conditions:

i. the PAD was not drawn in accordance with this authorization; or

ii. this authorization was revoked prior to a PAD being initiated.

I acknowledge that in order to be reimbursed, a declaration to the effect that either (i) or (ii) above took place, must be completed and presented to the branch of my financial institution holding the Account up to and including ninety (90) calendar days after the date on which such PAD in dispute was posted to the Account with respect to personal PADs, and ten (10) business days after the date on which such PAD in dispute was posted to the Account with respect to business PADs.

I acknowledge that the dispute of any PAD beyond the time allowed in this section is a matter to be resolved solely between me and Eurostar Academy Inc.

11. I warrant and guarantee that I am the person that can authorize withdrawals from the Account.

12. I understand and accept the terms of the Authorization as set forth above and indicate my acceptance by clicking on the “Agree” button.
Electronic Signature (Parent/Guardian):* *

I/We have read, understand and agree to comply with the PAYOR’S AUTHORIZATION FOR PRE-AUTHORIZED DEBITS (PADS)as outlined above
Name of Parent or Guardian *

First Name Last Name

Additional Services

Save time by registering now on the below items.
Would you like to add the cost of the Showcase ID Event to your biweekly payments? This will increase your biweekly payments accordingly. Highly recommended for U14-U18 Athletes.

Yes please add the ID Camp at a total cost of $275 [HST Included] No
Would you like to pay for 2 Showcase tournaments for your athlete now? Please note that this only pays for the tournament registration and coaching. It does not pay for everything else including visa procurement, travel insurance, accommodation, transportation and or any other cost that may arise.

Yes please add the two tournaments at a total cost of $395 [HST included] No I will pay the manager at a later date
Would you like to add the cost of the Lazio Camp to your biweekly payments? This will increase your biweekly payments accordingly. Highly recommended for U8-U13 Athletes.

Yes please add the Lazio Camp at a total cost of $325 [HST Included] No

Annual Fee

One time per year this fee covers player registration, administration and assists with the Academy's pre-paid expenses. Can be used to purchase equipment.
Would you like to add the cost of the new uniform for 2017-2018 to the annual payment. Highly recommended for existing members.

Yes please add $72 [HST Included] for the new uniform. No. I will purchase it upon pickup.
Would you like to add the cost of the player kit to the annual payment. Highly recommended for new members.

Yes please add $295 [HST Included] for the 16 item player kit. No I will purchase it upon pickup.
Calculation

Annual Fee *

CAD Description

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

You acknowledge making this agreement

This is a contract entered into by Eurostar Academy Inc. (hereinafter referred to as "the Provider") and {parentOr23} (Hereinafter referred to as "the Client") in {todaysMonthyear}.

The Provider's place of business is London, Ontario and the Client's residence is {address}.

The Client hereby engages the Provider to provide services described herein under "Scope and Manner of Services." The Provider hereby agrees to provide the Client with such services in exchange for consideration described herein under "Payment for Services Rendered."

Scope and Manner of Services
Service to Be Rendered by Provider:
- Provide Soccer Training and outdoor league competition for your son or daughter.
- Provide 2 invoices per year for the appropriate calendar year so that the Client can use such invoice for record keeping and any possible tax credits.
- Provide the Client with an electronic account on the Providers website to allow access to Client specific documents to assist with athlete development.
The Provider reserves the right to change the program outlined in section one (1) at any time by sending an electronic notice to the Client.

Payment for Services Rendered
The Provider delivers an annual program of soccer training and outdoor soccer league competition. The program begins on October 1st of the year of the contract and continues to September 30th of the following year. In consideration for the Providers services, the Client agrees to pay the applicable annual membership and all payments noted on the schedule earlier displayed. The Client understands that tuition for services to be rendered by the Provider is an annual commitment. The Client will be eligible to break down this annual payment into biweekly payments based on a Pre-Authorized Debit (PAD) Plan agreement as described earlier in this document. When registered through a PAD the Client gives the Provider authorization to collect past payments due longer than 30 days.

Liquidating Damages
Nonattendance for any reason by the Client’s participant/child does not constitute a notice of withdrawal from the program. Request for refunds must be submitted in writing to the Providers Academy Director PRIOR to the start of the annual session (October 1). Once the annual session begins there are no refunds under any circumstances. The client (parents) covenant and agree that (The Provider) shall be paid and shall retain Sixty per cent (60%) of the monies outstanding for the balance of the annual session as liquidated damages due and owing to Eurostar Academy (The Provider).

A $50.00 administration fee will be applied to all refunds. A fee of $42.50 will be charged for each bounced/insufficient payment. A late fee of $25.00 will be charged for any account past due by seven (7) days.

Client acknowledges making this agreement
This contract shall be governed by the laws of the province of Ontario and any applicable Federal law. This instrument constitutes the entire agreement between us and no statement, promises, representations or inducement made by any party hereto that is not contained herein shall be binding or valid. This contract may not be enlarged, modified, or altered, except in writing by both the parties.

The Client has read and understood the terms and conditions of this agreement, and by signing it voluntarily, the Client agrees to abide by these terms. In witness of their agreement to the terms above, the parties or their authorized agents hereby affix their signatures:
Name of Parent *

First Name Last Name
Signature *

Clear
Name of Player (if older then 13 years of age) *

First Name Last Name
Signature *

Clear
Should be Empty:

Street Address
Street Address Line 2
City	State
Zip Code	Country

Athlete Information

Parent or Guardian Information

Compliance

Biweekly Payments

Additional Services

Annual Fee