Seven Star Dragons HPS Karate Winter/Spring 2024 Sign-Up Sheet

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This is the sign-up sheet for Hyde Park School's Seven Star Dragons Karate Classes. Reserve your spot now by completing the questions below. Once complete, you will receive a link to a password protect page to pay your fees. A passcode will be sent via email.

Email *

Seven Star Dragons: HPS Karate at the Hyde Park School Dojo

Name of Parent or Guardian (Last, First) *

Name of Student Enrolling in Class (Last, First) *

Age of Student *

School Room Number of Student *

Grade Student Is In *

Mailing Address *

Zip Code *

Phone Number (XXX) XXX-XXXX *

Please Choose Which Classes Your Student Will Be Attending. Pay careful attention so that your child is enrolled in the proper classes. *

Winter/Spring 2024 Sign-Up School Year: Monday 2:15-3:15 pm 1st-4th Grade

Winter/Spring 2024 Sign-Up School Year: Monday 3:25-4:25 pm 3rd-4thth Grade with 2 Years Experience - Now accepting beginners

Winter/Spring 2024 Sign-Up School Year: Monday 3:25-4:25 pm 5th-6th Grade All Levels

Required

Emergency Contact Name & Phone Number (if different from parent/guardian)

MEDICAL: Please list any physical, emotional, or medical conditions that the instructor should be aware of (E.g. allergies, ADHD, joint problems, asthma, etc.). If none, type NONE. *

Dismissal: Where will your child go after class? *

Picked up by parent or guardian

Child will go to CRC

Please list parents/guardians (including phone number) with permission to pick up your child if not already provided. *

Payments & Sessions

You agree to pay in full, the amount of $145 per session and sign the waiver for each student. SESSION 2 dates January 22, 2024 - April 15, 2024.

Class sizes are limited! Please visit our website (link below) for online payments to reserve your spot in class.

Registration and payment must be complete to reserve your spot.

http://7stardragonskarate.com/index.php/hyde-park-school-dojo/

I have read and understand the Payments & Sessions terms. *

I have read and understand the Payments & Sessions terms and agree to pay the required fees in full.

Required

HPS Karate Agreement

I do hereby voluntarily submit my application for participation in the Hyde Park Karate Program, and I do assume all risk of personal injury including all losses which I may incur by my participation. Acting for myself, my heirs and my assigned, I do hereby release all claims against persons connected with Terrell Davis, 7 Star Dragons Karate, Hyde Park School, HPSPTO, CPS, Volunteers, or any of its employees from any and all liabilities. I understand this is a voluntary activity of which I am fit to participate in. I hereby grant permission for the use of photos and video while in program to be used on social media (e.g. Seven Star Dragons Facebook pages), 7stardragonskarate.com website, and correspondence to update families. I understand there is a $35 return check fee. There are no refunds after the first class.

Re: Covid-19 - Be assured we will follow CPS protocols. Despite careful attention to protocols, it is not possible to be assured there is no risk involved in participation. By participating, you accept the risk and consent to participate in class.

Please download the HPS Karate Agreement at the following link, sign it, and bring it to class.

THIS MUST BE DONE IN ORDER FOR YOUR STUDENT TO ATTEND CLASS!:

https://drive.google.com/file/d/1zBr9f4SjNJzpq9pUiCVH8c7WwqQfOtm_/view?usp=sharing

I have read and understood the HPS Karate Agreement. *

I understand and agree to the terms of the HPS Karate Agreement. IMPORTANT! HARD COPY MUST BE SIGNED AND TURNED IN FOR STUDENT TO PARTICIPATE.

I understand and agree to the terms of the HPS Karate Agreement with the exception of using images/videos of my student or myself. IMPORTANT! HARD COPY MUST BE SIGNED AND TURNED IN FOR STUDENT TO PARTICIPATE.

A copy of your responses will be emailed to the address you provided.

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