8/10/2019 After School TaeKwonDo Registration Form

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PARKS TAEKWONDO CLUB at J.F. BURNS ELEMENTARY

Session 2 (2014-15)

RSVP: Due January 12, 2015 (513) 469-7275

Who: Grades K & up (Beginners and up)For continuing students, Belt Promotion-Test will be offered. (Optional)

When: Mondays, 3:304:15 pm, for 8 weeksJan. 12, 26, Feb. 2, 9, 23 Mar. 2, 9 & 16

Where: Multipurpose Room.

Pick-Up Time: 4:15 pm SHARP!Due to another commitment by Master Park, it is critical that you be prompt about picking up your child

Thank you.

What: Learn; CONFIDENCE, SELF-CONTROL, RESPECT, FITNESS,

DISCIPLINE, TEAM WORK, POSITIVE ATTITUDE,

BULLY PREVENTION & MORE.

Registration: $120.00(make a check payable to Parks TKD)Or Sign-up over the phone by calling (513) 469-7275Free Uniform for New Students.

Minimum of 8 signups are required to hold the classes.

Please submit below portion toPark's TaeKwonDo Club

RSVP BY: January 12, 2015

Name:____________________________________ Age:_______ Height/Weight:____________/_____________

Address:________________________________________ City:______________________ Zip:______________

Phone Number:___________________ Email:___________________________ Payment Type: Cash/Check/Car

Credit Card #:_______________________________________ Exp:__________ Type: MC / Visa / Dis

Emergency Contact Person:__________________________ Phone:____________________ Relation:_________

LIABILITY WAIVER

In consideration of your acceptance of my registration in this club, I do hereby, for myself, my heirs, executors an

administrators waive, release and forever discharge any and all rights and claims for damages which I may have again

Parks TaeKwonDo Training & Fitness, J.F. Burns Elementary, and all members of the J.F. Burns, Parks TaeKwonDo Cluba

their respective officers, instructors, agents, representatives, successors, and/or assigns and against any students for any a

all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, an

which may arise out of traveling to, participating in, and/or returning from such athletic class. I fully understand th

TaeKwonDo is a sport and that injuries can occur during practice. In the event this application is for a minor, I warrant a

represent that I am the parent or legal guardian of such applicant and that I waive any and all rights and claims for damage

claimed for students contained herein.

Parent Signature__________________________________________________Date________________________