2021 Spring Break & Summer Camp (Early 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. *
Type initials above to consent
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.

Sunscreen & Lotion Policy

BGR8MA 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 pressence 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 BGR8MA 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 BGR8MA staff will use camp supplies to apply sunscreen as described above.
- Each child's parent/guadian must sign authorization for use and application of sunscreen/lotion on thier child(ren)
- 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 thier own or come to BGR8MA activities with sunscreen/lotion already applied before arrival. If assistance is needed it will be provided by staff ONLY if specifically authorized (see above).
I have read BGr8 Martial Arts sunscreen and lotion policy; as a result, I hereby *

Agree and give permission to apply DO NOT give permission for staff to apply
I GIVE PERMISSION for BGR8MA staff to administer sunscreen/lotion to my child(ren). I have read BGR8MA policies regarding the administration of sunscreen/lotion and agree to comply. I understand that BGR8MA is not responsible for non-compliance by my child. I further acknowledge that BGR8MA, 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. *
Type initials above to consent
I DO NOT GIVE PERMISSION for BGR8MA , 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 BGr8 Martial Arts activities and/or camps. I relieve BGR8MA, it's management, owners, assigned staff, officers, agents and employees from any liability resulting from not applying sunscreen and/or lotion. *
Type initials above to consent

Pricing, Payment, Policies & Procedures

BGR8 Martial Arts
SESSION RATES: Weekly Sessions 1-8- $169 / $150 for each additional sibling. The daily rate for camps is $52 per day and requires a three (3) day minimum. Field Trip costs are not included and will be billed weekly to your account. Field trip charge is $15 per week and $15 per day during Session 2 (Field Trip Extravaganza). *
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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. *
Type initials above to consent
SELECT SESSION DATE ($25 Non-refundable deposit per session / Remaining balance collected seven days before first day of camp)

Session 1 - Jurassic Attack (June 21-25)
How many children attending SESSION 1?
Session 2 - Field Trip Extravaganza (June 28-July 2)
How many children attending SESSION 2?
Session 3 - Among Us: Ninja Edition (July 5-9)
How many children attending SESSION 3?
Session 4 - Nerf Special Ops (July 12-16)
How many children attending SESSION 4?
Session 5 - Galactic Bounty Hunter (July 19-23)
How many children attending SESSION 5?
Session 6 - Mat is Lava: Obstacle Course Wk (July 26-30)
How many children attending SESSION 6?
Session 7 - Trick Shot Slime: Water Week (August 2-6)
How many children attending SESSION 7?
Session 8 - Lego: Brick Samurai Master (August 9-13)
How many children attending SESSION 8?
Credit Card Information (Name as appears on card): *

First Name Last Name
Credit Card Number *
First 4 digits of number
Credit Card Number *
Remaining digits of number
Security Code *
Expiration Date *
(Example: MMYYYY)
Postal Code *
CAMP HOURS: 9:00am-3:00pm. Free Extended Hours 7:30am-9:00am & 3:00pm-5:30pm. *
Type initials above to consent
FOOD AND SNACKS: I acknowledge that BGR8MA 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. *
Type initials above to consent
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. *
Type initials above to consent
WAVIER & RELEASE: Buyer(s) understands that Student(s) is engaging in physical activity, along with the use of BGR8 Martial Arts 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 BGR8 Martial Arts, it’s owners, its employees or agents for injury. Buyer(s) has carefully read this waiver & release and fully understands that it releases BGr8 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 BGR8 Martial Arts. Additionally, I hereby grant and authorize BGr8 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 and will not be returned. *
Type initials above to consent
LOSS/DAMAGE/THEFT: BGr8 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 initialing above that BGr8 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. *
Type initials above to consent
TRANSPORTATION RELEASE: I (parent or guardian) give my consent to BGr8 Martial Arts, its officers, agents, employees, individuals associated with the organization to transport my child(ren) named above to and from the authorized activities and events. *
Type initials above to consent
EMERGENCY MEDICAL: I (Parent or Guardian) give my consent to BGr8 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. *
Type initials above to consent
SICK POLICY: Campers, students, family members, guests, and vistors with fever, cough, sore throat 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 pick-up immediately. *
Type initials above to consent
COVID-19: I (Parent or Guardian) understand that BGr8 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, BGr8 Martial Arts cannot guarantee any vistor, 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 BGr8 Martial Arts, its owners, staff, instructors, partners or otherwise, for any and all injuries, claims, medical expenses or damages. *
Type initials above to consent
*Trade In Stock: I UNDERSTAND THAT BGr8 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 BGR8 MARTIAL ARTS IS NOT ASSUMING RESPONSIBILITY OR THE PROVISION OF DAILY CHILD CARE OUTSIDE OF THE PROGRAM. THE INTENT OF BGR8MA IS TO TEACH MARTIAL ARTS PHYSICAL AND PHILOSOPHICAL CHARACTER BUILDING SKILLS. *
Type initials above to consent
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). *
Type initials above to consent
EXTRA CHARGES: I acknowledge that my child must participate in field trips every TUESDAY or THURSDAY. As a result, I agree to a $15 field trip charge to be debited from my account the day of the field trip. I agree to a $15 per day field trip fee for Session 2 (Field Trip Extravaganza) with a maximum charge of $75 for the entire week. Due to COVID-19 and compliance with state regulations, I (Parent and Guardian) understand field trips and destinations are subject to change and/or agree to supplements. *
Type initials above to consent
CANCELLATIONS, REFUNDS & ABSENCES: We understand plans change. BGr8 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. *
Type initials above to consent
Sign Document *
Date Signed *

Month Day Year
Special notes or direction for staff members:
Should be Empty:

2021 Summer Camp Registration (EARLY REGISTRATION - Before Saturday, April 20,2021)

BGR8MA offers summer camps for children ages 5-12 with weekly themes and field trips that your kids are going to love!

Camp Sessions, Dates & Field Trips

ATTENTION: Due to COVID-19 precautions, summer camp weeks are being restricted to limited capacity.

Camper's Information

Parent Information

Emergency Contacts/Authorized Pickup

Medical / Health Information

Medication

Sunscreen & Lotion Policy

Pricing, Payment, Policies & Procedures