Digital Learning Camp Registration

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. List the name of at least two person 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.
Emergency Contact & Authorized Pick-Up #1
Full Name *

First Name Last Name
Primary Phone Number *
Secondary Phone Number
Relationship to Child *
Emergency Contact & Authorized Pick-Up #2
Full Name *

First Name Last Name
Primary Phone Number *
Secondary Phone Number
Relationship to Child *
Authorized Pick-Up #3
Full Name

First Name Last Name
Primary Phone Number
Authorized Pick-Up #4
Full Name

First Name Last Name
Primary Phone Number
Authorized Pick-Up #5
Full Name

First Name Last Name
Primary Phone Number
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. *
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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)
List the FIRST and LAST names of all persons unauthorized to pick up your child.

Pricing, Payment, Policies & Procedures
WEEKLY RATES: Weekly - $199 per participate (10% off 2nd person)collected on the Monday (7 days) prior to the first day of each camp week your child(ren) are attending. All payments are nonrefundable. *
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REGISTRATION FEE: A nonrefundable $150 registration fee per child is required to hold your spot and secure your child's digital learning device and school supplies. 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. *
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Payment
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Weekly Payment $ 199.00

2nd Person Discount $ 179.10

Total $ 0.00
CAMP HOURS: 8:00am-6:00pm. *
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FOOD AND SNACKS: I acknowledge that Twin Tigers Academy 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. *
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MINIMUM AGE: I acknowledge that my child will be at least 4 years of age on the first day of camp he or she attends and be registered for karate camp through Antioch, Discovery Bay, Brentwood, Oakley, Knightsen, Byron School District. *
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WAVIER & RELEASE: Buyer(s) understands that Student(s) is engaging in physical activity, along with the use of Twin Tigers Academy Of Self Defense 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 Twin Tigers Academy Of Self Defense, its employees or agents for injury. Buyer(s) has carefully read this waiver & release and fully understands that it releases Twin Tigers Academy Of Self Defense 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 Twin Tigers Academy Of Self Defense. Additionally, I hereby grant and authorize Twin Tigers Academy Of Self Defense 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 and will not be returned. *
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LOSS/DAMAGE/THEFT: Twin Tigers Academy Of Self Defense 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 initialing above that Twin Tigers Academy Of Self Defense 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. *
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TRANSPORTATION RELEASE: I (parent or guardian) give my consent to Twin Tigers Academy Of Self Defense, its officers, agents, employees, individuals associated with the organization to transport my child(ren) named above to and from the authorized activities and events. *
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EMERGENCY MEDICAL: I (Parent or Guardian) give my consent to Twin Tigers Academy Of Self Defense, 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. *
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SICK POLICY: Campers, students, family members, guests, and visitors with fever, cough, sore throat, extreme headache or other flu-like symptoms are not permitted until they have completed a 14 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 14 day self-quarantine. Any camper with a fever above 100.4 will not be permitted and will be required to be picked-up immediately. *
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COVID-19: I (Parent or Guardian) understand that Twin Tigers Academy Of Self Defense 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, Twin Tigers Academy Of Self Defense 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 Twin Tigers Academy Of Self Defense, its owners, staff, instructors, partners or otherwise, for any and all injuries, claims, medical expenses or damages. *
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*Trade In Stock: I UNDERSTAND THAT Twin Tigers Academy Of Self Defense IS A MARTIAL ARTS SCHOOL AND A LICENSED DAYCARE CENTER. THE SUPERVISION AND CARE OF MY CHILD(REN) IS INCIDENTAL TO THEIR PARTICIPATING IN THE PROGRAM AND THAT Twin Tigers Academy Of Self Defense IS NOT ASSUMING RESPONSIBILITY OR THE PROVISION OF DAILY CHILD CARE OUTSIDE OF THE PROGRAM. THE INTENT OF Twin Tigers Academy Of Self Defense IS TO TEACH MARTIAL ARTS PHYSICAL AND PHILOSOPHICAL CHARACTER BUILDING SKILLS. *
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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). *
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LATE PICKUP POLICY: If you are unable to be on time for the scheduled pickup. The Late Pickup fee will charge you $1 per minute.
CANCELLATIONS, REFUNDS & ABSENCES: Due to the limited participation and nature of camp, no refunds, credits, or transfers are available for sick days or absences for any reason. *
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Sign Document *
Date Signed *

Month Day Year

Payment Methods

Debit or Credit Card

First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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2021 Karate Camp Registration

Twin Tigers Academy offers Karate Camp for children ages 4 & up for parents looking for a solution to send their kids to a camp.

ATTENTION: Due to COVID-19 precautions, digital learning camps are being restricted to limited capacity.

Camper's Information

Parent Information

Emergency Contacts/Authorized Pickup

Medical / Health Information

Medication

Pricing, Payment, Policies & Procedures