2022 Summer Camp Registration These forms are required for your children to attend camp. Campers must be at least 5 years of age on the first day of camp they are attending. Please provide any additional information that you think is important or may affect the camper's ability to fully participate in the camp program. Parent / Guardian Information
Where would you like to be reached while your child is at camp?
Where would you like to be reached while your child is at camp?
Emergency Contact & Authorized Pick-Up Parents cannot be listed as emergency contacts. List the name of at least two people who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of the studio/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18. AUTHORIZED PICK UP POLICY: Only the people listed above may pick up your child from camp. No exceptions are made for family members without advanced written notice prior to pick up. Please provide the names of persons who are UNAUTHORIZED to pick up your child: (These people are specifically NOT allowed to pick up your camper) Medical / Health Information
Does your child have any food, medication or environmental allergies?
Does your child have a special health or medical condition?
List any history of hospitalization, outpatient surgery, or previous health concerns that would be needed to assist the staff or medical personnel in an emergency situation.
Is there any medication that needs to be administered during the day at camp?
If yes, please provide a detailed list to include name of medication, exact dosage, when medication needs to be administered and any other instructions staff members need to be aware of. Sunscreen and Lotion Policy
In the event of any outdoor activities, Family Kicks Championship Martial Arts staff will assist in applying sunscreen and/or lotion to children attending camp. I (parent or guardian) understand that this may require the staff member to touch my child's face, shoulders, back, arms, and lower legs. Sunscreen and/or lotion will be applied in the presence of other staff members. I understand that staff will not apply sunscreen/lotion to any child's front torso or upper legs, but will assist and/or direct the child to do so. I understand that no Family Kicks Championship Martial Arts staff member will be allowed to apply any sunscreen, lotion or ointment to any area that would be covered by a bathing suit for any reason. In the event that any child does not bring sunscreen to activities/camp and conditions warrant it's use, members of Family Kicks Championship Martial Arts staff will use camp supplies to apply sunscreen as described above.
Sunscreen and/or lotion containers must be labeled with the child's full name and must be provided to staff upon check-in.
Children should, in most instances, apply the sunscreen/lotion on their own or come to Family Kicks Championship Martial Arts activities with sunscreen/lotion already applied before arrival. If assistance is needed it will be provided by staff ONLY if specifically authorized (see above).
By giving permission for Family Kicks Championship Martial Arts staff to administer sunscreen/lotion to my child(ren). I acknowledge that I have read Family Kicks Championship Martial Arts policies regarding the administration of sunscreen/lotion and agree to comply. I understand that Family Kicks Championship Martial Arts is not responsible for non-compliance by my child. I further acknowledge that Family Kicks Championship Martial Arts, it's directors, officers, agents, employees, and staff shall have immunity from any liability from damages, injuries, allergies, or reactions resulting from the administration of the sunscreen and/or lotion provided.
If I choose to NOT GIVE PERMISSION for Family Kicks Championship Martial Arts, it's directors, officers, agents, employees, and staff to assist in applying sunscreen to my child(ren), I further agree to take FULL responsibility to apply sunscreen/lotion prior to arrival of all Family Kicks Championship Martial Arts activities and/or camps. I relieve Family Kicks Championship Martial Arts, it's management, owners, assigned staff, officers, agents and employees from any liability resulting from not applying sunscreen and/or lotion. *
I have read Family Kicks Championship Martial Arts sunscreen and lotion policy; as a result, I hereby
Pricing, Payment, Policies & Procedures SESSION RATES: Weekly - $185 / $175 for each additional sibling. The daily rate for camps is $52 per day and requires a three (3) day minimum and subject to availability. SESSION DEPOSITS: A nonrefundable $25 deposit is required to hold your spot. Deposits paid will go towards weekly camp rate. The balance will be collected on the Monday (7 days) prior to the first day of each camp week your child(ren) will be attending. If the credit card is declined, your child will be removed from the camp roster and your place will be filled from the waiting list forfeiting paid deposit if we are unable to reach you within 24 hours. Deposits are non-transferable and cannot be applied to another session. CAMP HOURS: 9:00am-3:00pm. Free Extended Hours 7:30am-9:00am & 3:00pm-5:30pm. FOOD AND SNACKS: I acknowledge that Family Kicks Championship Martial Arts will not provide food and snacks during the camp, and it is my responsibility to send my child each day with lunch, two snacks and water bottle. MINIMUM AGE: I acknowledge that my child will be at least 5 years of age on the first day of camp he or she attends. WAIVER & RELEASE: Buyer(s) understands that Student(s) is engaging in physical activity, along with the use of Family Kicks Championship Martial Art’s facilities, equipment, training and instruction, which can be dangerous and could cause injury. Therefore Buyer(s) assumes all risk of injury to said Student(s). Buyer(s) / Student(s) hereby waives and releases any claim or right to sue Family Kicks Championship Martial Arts, its employees or agents for injury. Buyer(s) has carefully read this waiver & release and fully understands that it releases Family Kicks Championship Martial Arts of all liabilities for any injury that may occur. It is always advisable to consult your physician before undertaking a physical activity program, particularly those performed at Family Kicks Championship Martial Arts. Additionally, I hereby grant and authorize Family Kicks Championship Martial Arts the right to take, edit, copy, publish, distribute and make use of any and all photos or video taken of my child(ren) to be used in and/or for legally promotional materials and digital communications. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing. I understand and agree that these materials shall become the property of Family Kicks Championship Martial Arts and will not be returned. LOSS/DAMAGE/THEFT: Family Kicks Championship Martial Arts does not assume any responsibility for the loss, damage, or theft of any property belonging to the Buyer(s)/Student(s) and I agree by checking below that Family Kicks Championship Martial Arts and its personnel are not responsible or liable for any such property in the event of loss, damage, or theft on or about the facility. EMERGENCY MEDICAL: I (Parent or Guardian) give my consent to Family Kicks Championship Martial Arts, its officers, agents, employees, individuals associated with the organization or any emergency medical personnel to administer necessary treatment to my child (named above) in the event of an emergency and authorize transportation for child by ambulance if situation warrants. I agree to assume responsibility for the payment of the emergency treatment. SICK POLICY: Campers, students, family members, guests, and visitors with fever, cough, sore throat or other flu-like symptoms are not permitted until they have completed a 5 day self-quarantine. People who have traveled to a high-risk area for COVID-19 are not permitted or had contact with a person known to be infected with COVID-19 are not permitted until they have completed a 5 day self-quarantine. Any camper with a fever above 100.4 will not be permitted and will be required to be picked-up immediately. COVID-19: I (Parent or Guardian) understand that Family Kicks Championship Martial Arts has implemented steps and procedures to reduce the risk and spread of COVID-19 in accordance with state and federal guidelines. However, due to the nature of the novel coronavirus, Family Kicks cannot guarantee any visitor, guest, student or camper entering our facility will not be potentially at risk. By entering our facility, you hereby assume full responsibility and waive all claims against Family Kicks Championship Martial Arts, its owners, staff, instructors, partners or otherwise, for any and all injuries, claims, medical expenses or damages. *Trade In Stock: I UNDERSTAND THAT FAMILY KICKS CHAMPIONSHIP MARTIAL ARTS IS A MARTIAL ARTS SCHOOL AND NOT A DAYCARE IN AS SUCH, THEIR STOCK-IN-TRADE IS NOT SUPERVISION AND CARE. THE SUPERVISION AND CARE OF MY CHILD(REN) IS INCIDENTAL TO THEIR PARTICIPATING IN THE PROGRAM AND THAT FAMILY KICKS CHAMPIONSHIP MARTIAL ARTS IS NOT ASSUMING RESPONSIBILITY OR THE PROVISION OF DAILY CHILD CARE OUTSIDE OF THE PROGRAM. THE INTENT OF FAMILY KICKS CHAMPIONSHIP MARTIAL ARTS IS TO TEACH MARTIAL ARTS PHYSICAL AND PHILOSOPHICAL CHARACTER BUILDING SKILLS. DISCIPLINE POLICY: In an effort to provide your child and other students with a safe and fun experience, it is necessary that all students exhibit proper behavior, self-discipline and self-control. Correcting unsatisfactory behavior is time consuming and distracts from providing quality, safe, educational, and fun activities for the rest of the students. If we are unable to control a situation, we will contact the parents first by telephone at or near the disturbance, so that the parent may reinforce (by phone) the requirement that all students enrolled in the summer camp program behave satisfactory and follow instructions fully and promptly. Students that cannot be controlled by verbal commands or that are a constant disciplinary problem will be suspended from the program(s). TECHNOLOGY, ELECTRONICS & PERSONAL DEVICES: Campers are NOT permitted to bring electronic devices (including but not limited to video games, tablets or digital music devices). Children with cell phones will only be allowed to use device to communicate with parents and will not be permitted to use device for any additional reason. Family Kicks Championship Martial Arts assumes no liability for lost or stolen items. CANCELLATIONS, REFUNDS & ABSENCES: We understand plans change. Family Kicks Championship Martial Arts will gladly issue a refund (minus the required $25 deposit) for any cancellation request received in writing more than 14 days before the scheduled session date. No refunds, credits, or transfers are available for sick days or absences for any reason. Family Kicks Championship Martial Arts will gladly allow campers to change session dates at any time if the requested session is available; however, deposits are not transferable to new session dates and a new deposit will be required. Additional notes or instructions for staff members
Please choose which sessions you would like to register fo. A $25 non-refundable deposit is required for each week selected.
Please click the 'Submit Registration' button below to submit your request for the camp dates you've selected. Please note that your registration is not complete and your spot is not guaranteed until the required deposit has been received. Thank you for submitting your registration! A staff member will contact you shortly to finalize your registration.