Camp & Event Registration Form

Camp & Event Registration Form

Choose Event

$
$

Child Information

First Name
Last Name

Sibling Information

First Name
Last Name

Parent/Guardian Information

First Name
Last Name
Address
Street Address
Street Address Line 2
City
State/Province
Zip/Postal
Country

Medical Information

First Name
Last Name

Acknowledgement and Agreement

For convenience and for the environment, Encinitas Karate utilizes on line forms for events and authorization. Please read the following section carefully. You will be asked for your authorization as your agreement to said policies. You will receive a copy of your agreement via email provided above. Invalid email or no authorization will result in a forfeited camp agreement and spots requested.

Late Pick Up Policy and Charges

The first 10 minutes is no charge, after 10 minutes it is a $10 charge plus $1 a minute
per child.

Reservations and Cancellation Policy

Payment in full is required to reserve spot(s). A minimum of 8 attendees must be
registered and paid in full for game night to occur. A full refund will be given in the
event of Encinitas Karate cancels game night. You can cancel any game night up to
48 hours prior to game night, receiving a full refund. You can cancel a camp under 48
hours of the game, receiving a full credit for the game night to be applied to a future
game night event.

Authorization and Finalization

I the designated parent or person having legal custody or guardianship of the minors shown above, or for myself, give permission for these minors to participate in all activities as described in the announcement for the program event. I hereby voluntarily and knowingly assume all risks and dangers inherent and incidental to the activities of the program. I will not hold Encinitas Karate, its instructors, employees or other attending guests or parks visited liable for any injuries incurred during the program whether caused by equipment on or off site from building or the acts or omissions of others excepting, damage or injury soley caused by the willful misconduct of negligence of Encinitas Karate or its employees or agents. I the undersigned parent or person having legal custody or guardianship of the minors shown above acknowledge that there is no existing medical condition, food allergy and/or other condition of importance that is not listed above in section Other Info that will prohibit the mentioned minors above to participate in activities listed in the events announcement. I also acknowledge that all minors must be over the age of 5. I understand by signing below that I agree to the policies and have filled out this registration form accurately and to the best of my knowledge. Photography and/or Video Media will be utilized during the event and I acknowledge that Encinitas Karate has full rights and ownership to said media which will or can be used to market similar events for Encinitas Karate I waive the right to any compensation for pictures or videos taken and used by Encinitas Karate. I understand that Encinitas Karate can change activities, themes or guest speakers at any time and that Encinitas Karate is not responsible for Guest Speaker cancellations or agenda changes.

Guardian's Electronic Signature and Authorization*
Guardian agrees to abide by the policies set by Encinitas Karate