Please enter your full name in the space below. 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. I represent that I am the person who appears on the application above. BILLING INQUIRIES - 88 or by mail to PO Box 297, Hatboro, PA 19040. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. MSI is not responsible for any bank fees incurred by Customer. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. Any returned payment will be assessed a $25.00 fee.
Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*UNITEDSTATESJUJITSUF 8882448044 ONLINE REG FEE".
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. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Billing and payment processing for Businesses' events is performed by Member Solutions, Inc.
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