Adult Clinic Registration Form Unlimited Adult Tennis Clinics for only $99 per month. Limited Time Offer. Please complete the form below. Personal InformationName* First Last Address* Street Address City State / Province / Region ZIP / Postal Code Email* Enter Email Confirm Email Cell Phone*Please select your gender.*MaleFemalePlease choose a Username and PasswordWith this username and password you will be able to log-on to your own private "My Account" Page on our web-site.Have you previously chosen a Username and Password? Yes No Please choose a Username.*Please choose a Password.* Enter Password Confirm Password You will receive a confirmation email that contains your username and password.* OK. Registration into our Limited Time OfferI would like to sign up for the limited time offer of attending as many adult classes each month for only $99.* Yes, Sign me up. Please enter today's date below.Your first month's payment will be pro-rated.Day*Select Day12345678910111213141516171819202122232425262728293031Month*Select MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberYear*Select Year201920202021Adult Special Offer Price: $99.00 Pro-Rated Amount to be charged today for the remainder of this month. Price: $0.00 Let's continue with this form.* OK. IMPORTANT BILLING INFO - PLEASE READ CAREFULLYAutomatic Recurring Billing begins with the submission of this form. Following the first month's prorated payment, your card will be charged on the 1st day of each month. You may cancel these recurring payments at anytime provided that you give Rob Nickels Tennis Inc. 15 days notice prior to the next scheduled automatic payment and by submitting the online cancellation form as explained below.Subscription Payment Policy:*By checking the box, I authorize Rob Nickels Tennis Inc to charge the credit or debit card indicated in this authorization form according to the terms selected in this registration form. Submission of this form is for payment authorization for monthly Automatic Recurring Payments. The first month’s payment will be pro-rated and then $99 amount will be charged to your credit or debit card on the 1st day of the following months. I certify that I am an authorized user of this credit or debit card and that I will not dispute the scheduled payments with my credit card company provided the transactions correspond to the terms indicated in this authorization form. There will be no refunds and no prorating of future monthly fees. I completely understand that my recurring payments will remain in effect until I notify the business by submitting the online cancellation form at least 15 days prior to the next automatic payment. I have read and agree to the Subscription Payment Policy. Subscription Cancellation Policy:*To cancel or pause recurring payments Rob Nickels Tennis Inc. requires the online Cancellation Form to be submitted. This form is located at https://cityofparklandtennis.com/my-account-information-adult-program/. Absolutely no other form of cancellation notification will be accepted. Rob Nickels Tennis Inc. require 15 days advanced notice prior to your next monthly recurring payment to stop the next payment from processing. Cancellation forms submitted with less than 15 days prior to the next payment will result in one more payment being processed as normal. I understand that absolutely no refunds or credit will be granted if the 15 days’ prior notice has not been provided. I have read and agree to the Subscription Cancellation Policy. Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name This limited time offer is brought to you by Rob Nickels Tennis Inc. and the City of Parkland.