Academy 2.0 RegistrationAcademy 2.0 participants may use the following form to register and pay for monthly (unlimited) sessions & recurring billing.Player Name* First Last Grade Level*Select OneKindergarten1st2nd3rd4th5th6th7th8th9thBasketball Playing Experience*BeginnerIntermediate (has played in a recreation league)Advanced (has played club or other competitive level)Player's Age*How did you hear about us?*Google searchFacebook adsInstagramFriend or familyFlyerYard signMagazine articleOtherParent / Contact InformationName* First Last Parent Email Address* Email Confirm Email Parent Cell Phone*Emergency Contact Name* First Last (Other than parent/guardian listed above)Emergency Contact Phone*MembershipAcademy 2.0 PlanUnlimited Academy 2.0 Trainings ($125/month - up to 16 hours)(1) Academy 2.0 Training per Week ($69/month - up to 8 hrs)Processing fee will be added at total.Recurring Payment*Do you acknowledge a recurring monthly payment for your Academy 2.0 fees? By clicking "Yes" below, you will authorize a credit card payment to Team Nikos, to take place every month from the date of this registration.YesNoUnlimited Contract Promo6 Month Unlimited Promo12 Month Unlimited Promo 6 Month Promo Details Original Price $125.00 per month Special Price $104.00 per month 12 Month Promo Details Original Price $125.00 per month Special Price $93.75 per month Recurring PaymentDo you acknowledge a recurring monthly payment for your Academy 2.0 fees? By clicking "Yes" below, you will authorize a credit card payment to Team Nikos, to take place every month from the date of this registration.YesNo6 or 12 Month Contract BillingAs detailed above, the months that are free are factored into the monthly payment, thus substantially reducing that payment. There will not be months that you do not receive a bill. Please Note: No refunds are allowed for any reason during the contract periodI UnderstandAre you registering a new player for Academy 2.0?*All new Academy 2.0 players are required to purchase and wear a reversible Academy 2.0 jersey ($25) to all sessions and pay the initiation fee ($25). Please pick up your jersey the first time you attend Academy 2.0.New Player (Academy 2.0 Jersey + Initiation Fee)Returning PlayerJersey Size*(Black / White / Gold)Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult LargeAdult XLAdult XXLAdditional Academy 2.0 Jersey(s)*(Black / White / Gold) – $30 ea.None(1) Additional Jersey(2) Additional Jerseys(3) Additional JerseysT-Shirt(s)*(Gray / White / Gold) – $20 ea.No T-Shirt(1) T-Shirt(2) T-Shirts(3) T-ShirtsT-Shirt 1 Size*Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult LargeAdult XLAdult XXLT-Shirt 2 Size*Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult LargeAdult XLAdult XXLT-Shirt 3 Size*Youth SmallYouth MediumYouth LargeYouth XLAdult SmallAdult MediumAdult LargeAdult XLAdult XXLAcademy 2.0 has a "No Refunds" policy.*a. It is the customer's responsibility to pick up their apparel at the Ladera Sports Center during an Academy 2.0 session within 30 days of purchase. b. No Refunds or warranty on all Apparel items c. No Shipping of any apparel items I understand. Credit Card InformationCredit Card* DiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name Signature*I understand that I am committing to a minimum of one (1) month, and to change, pause or cancel my membership, I must contact Team Nikos.I agree and understand that there are no refunds for any reason.*I Agree and UnderstandMonthly Recurring Fee SubtotalIncludes Processing Fee Price: $0.00 Apparel & Initiation Fee Subtotal:(One-Time Fee) Price: $0.00 Total:Waiver* The sporting activity in which I will participate involves significant risk of personal injury, including the risk of death and permanent disability. I hereby assume all such risks, known and unknown, foreseen and unforeseen, and assume full responsibility for my participation in such activity. I will comply with all policies, instructions, rules and regulations and directions related to my participation in such activity. For myself and on behalf of my heirs, assigns, next of kin and personal representatives, I hereby indemnify, release and hold harmless TEAM NIKOS BASKETBALL ACADEMY (TNBA), LADERA RANCH NJB (LRNJB) AFFILIATE COMPANIES, and its officers, employees, members, agents, representatives, and other sports participants as well as LADERA SPORTS CENTER (LSC), and its officers, employees, members, agents, representatives, and other sports participants from and against any and all claims, losses or damages, including, without limitation, any and all personal injury, disability, death and damage to personal property arising directly or indirectly from my participation in such activity, to the extent permitted by law. I have no medical condition that could impair my safe participation in such activity. I acknowledge that TEAM NIKOS BASKETBALL ACADEMY (TNBA) & LADERA RANCH NJB (LRNJB) does not maintain medical insurance for me. If I have a medical emergency, I hereby grant TEAM NIKOS BASKETBALL ACADEMY (TNBA) & LADERA RANCH NJB (LRNJB) permission to administer or have administered whatever emergency medical care it deems necessary for my welfare and I shall be responsible for any costs incurred by TEAM NIKOS BASKETBALL ACADEMY (TNBA) & LADERA RANCH NJB (LRNJB) in providing such medical care. I give permission for my child(ren) to be photographed, or their images recorded for print or electronic use in promoting our child sports services. I understand that it is my responsibility to update this form in the event that I no longer wish to authorize the above uses. I agree that this form will remain in effect during and after the term of my child’s enrollment with TEAM NIKOS BASKETBALL ACADEMY (TNBA) & LADERA RANCH NJB (LRNJB). I understand that there will be no payment for me or my child’s participation I agree to the Team Nikos terms of service Would you like to stay connected with the latest information and specials?Sure thing!No, thank youNameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.