Union UTA Martial Arts/SAMI UNION: Online Board Order form

Attention Blue and Above!!!!!

Board stacks will be sold in stacks of 5.

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Order forms due back no later than August 25^th

Board Size is based on age. Please read carefully and know what your requirements are.

Colored belt students age 9 and under- �� thick boards:

5 Boards $15_______ 10 Boards $30_______ 15 Boards $45_______ 20 Boards $60_______

Colored belt 10 to 12 & Black belt Jr�s- 1� Thick by 8� boards:

5 Boards $15_______ 10 Boards $30_______ 15 Boards $45_______ 20 Boards $60_______

All Students 13 and up- 1� thick by 10� Boards:

5 Boards $15_______ 10 Boards $30_______ 15 Boards $45_______ 20 Boards $60_______

(Adults age 18 and over must do DOUBLE breaks on half their stations)

INFO:

Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and/or are not selectable.

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When would you like to pay?

Registrant Fee:		$0.00
Group Fee:		$0.00
Registration Fee:
Quantity Discount:		-
Promotional Discount:		-
Subtotal:
Online convenience fee:		$0.00
Delayed Payment Surcharge:
Total Fee:

Billing information

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Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*UNIONSUNITEDTAEKWOND 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

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Registration inquiries:
Union UTA office Staff
office_manager@unionuta.com
(908) 687-5559

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Registrant

use this registrant for billing information

First Name

Last Name

Age 9 and Under (colored belt)- Please select how many stacks of 10 you need

Colored belt age 10-12 and ALL Black belt jr's- Please select how many stacks of 10 you need

13 and over- Please select how many stacks of 10 you need

Tax will be included in final cost

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