25-26 After School Form Logo
  • After School Program

  • Legacy Martial Arts After-School 2025-2026

  • Student Information

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  • Parent/Guardian Information

  • Enrollment Authority

    I have legal authority to enroll this student in the Legacy Martial Arts After-School Program. i accept this responsibility for this enrollment.

  • Secondary Parent/Guardian Information

    secondary Information is not required
  • Emergency Contact/Pickup Information

  • At least one Emergency Contact person (NOT a parent or guardian already listed) must be entered. This will be used if we can NOT reach the parent(s) / gaurdian(s) listed above.  

  • The following individuals are authorized to pickup the student (optional)

  • Transportation

  • Authorization for Transportation

    I authorize Legacy Martial Arts to transport my student(s) from schoolto the Leagacy Martial Arts location. I also approve transportations on school sponsored field trips.

  • Medical Information

  • Authorization for Emergency Medical Treatment

    In the event I cannot be reached to make arrangments for emergency medical attention, I authorize the staff of Legacy Martial Arts to seek emergency medical treatment. This includes but is not limited to calling 911.

  • Doctor or Urgent Treatment Center Information

  • In the event of a medical emergency when parents / guardians can not be reached, we must have acces to medical history for the student in order to provide access to the this information for EMS.

  • Immunizations & Vision and Hearing Screenings

  • The student's immunization record is on file at the public/private school the student attends. All immunizations are current. All necessary Vision and Hearing Screenings as required by the Special Senses and Communication Disorders Act are current and on file at the students school.

    At this time Legacy Martial Arts does not require staff members to have specific immunizations or vacinations.

  • Fees

  • Registration Fee

    There is a $35 non-refundable Registration Fee for Existing students includes

    T-Shirt. And $85 for New Students required before enrollment will be accepted

    (Uniform, T-shirt and 1/2 off the first week for a total $115) for the first week. There are also fees associated with the martial arts training (Test fees, sparring gear, clinics). These fees only apply when you approve of the purchase/ clinic / belt test, ect.

    Please indicate your payment preference below.

    Weekly Tution /   Monthly           4 Weeks             5 Weeks

    Current Students: $60/Weekly     $240/Monthly     $300/Monthly

    Sibiling:               $120/Weekly   $480/Monthly     $600/Monthly

    Siblings(3):          $180/Weekly   $720/Monthly     $900/Monthly

  • Waiver & Financial Obligations

  • Liability Waiver

    I am giving permission for the student listed on this form to participate in the 2024-25 Legacy Martial Arts After School Program. I realize the staff and instrutors will do everything in their power to protect my child when in their care. I will not hold them responsible and waive all claims against Legacy Martial Arts for any accidents that may occur when the student is in their care. I also acknowledge that Legacy Martial Arts does not provide medical insurance coverage for accidents. 

  • After-School Operational Policies Document

  • I have read and acknowledge the content of the Legacy Martial Arts After-School 2024-25 Operational Policy Document", also includes our "Discipline and Guidance Policy"

    Parents: Please take a moment to read the "After-School Operational Policies" it will answer many of your qestions about our program and how we operate on a daily basis.

  • Financial Obiligations

  • I agree to all financial obligations related to my students attendance in the 2024-25 Legacy Martial Arts After-School Program. These obligations are defined in the 2024-25 Legacy Martial Arts After-School Program Operational Policies Document(available on the Legacy Martial Arts website). I have reviewed this document and agree to the obligations.

    Forms are available at the Front Desk to provide Credit Card and ACH Transfer information.

  • Final Step !!!

  • Final Enrollment Step

    To complete your enrollment, you must physically sign (ink) the "Approved" enrollment form. Your enrollment form will be printed at the Karate School and you will be asked to sign it only once.

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