2025~2026 After School Registration Form

🅰️+ After School Program

Now Enrolling – Limited Spots Available!

Due to safety considerations, we are accepting only a limited number of students.

Reserve your child’s spot today with $0 down!

Why Choose K White Tigers?

Your child’s safety and success are our top priorities.

✅ Our instructor is certified in First Aid, CPR, and AED, and is equipped with a professional choking rescue device.

✅ We provide a safe, structured, and enriching environment after school.

Program Highlights:

Daily Transportation from schools

Martial Arts Classes & Healthy Snacks included in tuition

Early Dismissal Pick-Up available

Supervised Homework Time

No Extra Charge for Student Holidays & Inclement Weather Day Camps

(A $70/day value – included)

Empowered Learning Center

(Optional Tutoring in Reading, Writing, and/or Math)

📍 K WHITE TIGERS MARTIAL ARTS

📞 703-724-0022

📧 kwhitetigers@gmail.com

1st Child's Name*

First NameLast Name

Birth Date*

MonthDayYear

Gender*

MaleFemale

School*

Grade*

Please Select After Care Program*

Please Select Day*

Start Date*

Date

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

2nd Child's Name

First NameLast Name

Birth Date

MonthDayYear

Gender

MaleFemale

School

Grade

Please Select After Care Program

Please Select Day

Start Date

Date

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Parent/Guardian Information

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Number*

E-mail*

example@example.com

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Alt. Phone Number

K WHITE TIGERS MARTIAL ARTS
Informed Consent, Acknowledgement, and Release of Liability

1. Participation Consent
I, the undersigned parent or legal guardian, hereby give permission for my child to participate in all activities organized by K WHITE TIGERS MARTIAL ARTS (hereinafter referred to as “K WHITE TIGERS”) during the enrolled program or camp sessions.

2. Assumption of Risk and Release of Liability
I understand that participation in sports, martial arts, transportation, and other physical activities inherently involves risk, including but not limited to, the risk of bodily injury (such as fractures, sprains, paralysis), illness, or even death.

In consideration of my child’s participation, I hereby assume all risks and hazards incidental to the conduct of activities, and I do hereby waive, release, absolve, and hold harmless K WHITE TIGERS, its owners, officers, employees, agents, volunteers, and representatives, from any and all claims, liabilities, or causes of action arising out of or in connection with my child’s participation in, travel to and from, or involvement in any program activities, to the fullest extent permitted by law.

3. Medical Authorization
In the event of an emergency, I authorize K WHITE TIGERS to take all reasonable steps to secure necessary medical treatment for my child, including transportation to a hospital or clinic. I understand that reasonable efforts will be made to contact me or the emergency contact listed on my child’s registration form prior to such action. I accept full financial responsibility for any medical services rendered.

4. Program Consent and Transportation Authorization
I grant permission for my child to be transported to and from school and/or program-related events by K WHITE TIGERS staff or designated personnel.
I further grant permission for my child’s name, image (photograph or video), or quotes to be used in promotional materials including print, digital media, and social platforms without compensation or further consent.

5. Property Disclaimer
I understand that K WHITE TIGERS is not responsible for the loss or theft of personal property brought onto its premises or during program-related activities.

6. Tuition and Payment PolicyTuition is billed monthly at a flat rate for each 4-week session, regardless of actual attendance.
The first month's tuition (or prorated amount) is due at the time of registration.
Monthly tuition will be automatically deducted from the bank account or credit card on file.
Cancellation requires a written notice at least 30 days in advance.
Refunds, if applicable, will be prorated based on individual pricing.

7. Acknowledgment and Agreement
By signing below, I acknowledge that I have read, understood, and agreed to all the terms above. I understand that this agreement is binding upon me, my heirs, executors, administrators, and assigns.

After School Registration

Student's Information