Evolve Martial Arts Summer Camp Form

Evolve Martial Arts Summer Camp

2024
Permission to Ride Form

Summer Camp 2024
Student(s) Name
Emergency Contact (Relationship)
Emergency Telephone number
I (We) blankshereby grant permission for Evolve Martial Arts Representatives to transport the above student(s) to Summer Camp activities located at 23485 Fern Crescent, Maple Ridge, BC V4R 2S6 (WildPlay), Meadowtown Centre, 19800 Lougheed Hwy. #410, Pitt Meadows, BC V3Y 2W1 (Cineplex), 19840 96 Ave #3, Langley Twp, BC V1M 3B9 (CircusLab), and/or 11455 201a St, Maple Ridge, BC V2X 0Y3 (The Rock Wall) on the following days:
Summer Camp Excursion:

(Week 1) Wednesday, July 10, 2024: WildPlay(Week 2) Tuesday, July 23, 2024: The Cineplex Odeon Meadowtown Cinema(Week 3) Wednesday, August 14, 2024: Circus Lab(Week 4) Wednesday, August 21, 2023: The Rock Wall
Students will be travelling in the following manner:
- Private passenger vehicle/van with logo.
Parent Phone Number
Please enter a valid phone number.
Signature of Parent/Guardian

Clear
Date

MonthDayYear
Date
Registration Form
Select Camp:*

Week 1: July 8- 12, 2024Week 2: July 22- 26, 2024Week 3: August 12- 16, 2024Week 4: August 19-23, 2024Drop in:
Drop-in Date(s):
Child's Name*

First NameLast Name
Age:*
Gender*

MaleFemaleOther
PARENT / GUARDIAN Information:
Name of Parent/Guardian #1:*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Name of Parent/ Guardian #2:

First NameLast Name
Phone Number
Emergency Contact Information:
EMERGENCY CONTACT (NAME)*
RELATIONSHIP*
TELEPHONE*
NAME AND PHONE NUMBER(S) OF PERSON(S) OTHER THAN PARENTS ALLOWED TO PICK UP YOUR CHILD
1.
PHONE
2.
PHONE
3.
PHONE
MEDICAL RELEASE FORM
Student Name*
Birthdate*

MonthDayYear
Date
Parent/Guardian Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone #*
Email*
example@example.com
Alternate Phone#
Physician's Name
Phone #
My child has the following medication conditions or allergies that may affect him/her in participating Tae Kwon Do or that may affect medical care authorized below: (If no conditions or allergies, mark with the word "None" and your initials)
(If no conditions or allergies, mark with the word "None" and your initials)
In the event neither parent nor the doctor listed above can be contacted, I hereby authorize Evolve Martial Arts to obtain emergency medical care for my child when such medical care will be for the best interested of the child and should not be delayed pending consent of the parents for family doctor.

Iunderstand that Evolve Martial Arts has no insurance which pays for the medical or hospital costs that might be incurred on behalf of my child. Consequently, I understand that all costs shall be my sole responsibility.
Parent / Guardian Signature*

Clear
Date*

MonthDayYear
Date
RELEASE OF ALL CLAIMS and WAIVER OF LIABILITY

By signing this Waiver and Release of Liability, you, your family, and representatives give up the right to sue. TO: Evolve Martial Arts (the "School") IN CONSIDERATION OF the School permitting me to participate in Tae Kwon Do activities, classes, lessons or events at the school (the "Tae Kwon Do Activities") on behalf of myself, my heirs, personal representatives executors, successors, administrators, assigns and whomsoever else may have an interest either at common law or by operation of statutes, I agree to and do hereby waive any and all claims I or they may have now or in the future and release from all liability, and agree not to sue, the School, or any of its directors, officers, employees, agents, or representatives (collectively the "Releases") for any personal injury, death, property damage or other loss suffered or sustained by me resulting from my Tae Kwon Do Activities due to any cause whatsoever, including without limitation, negligence on the part of any of the Releases. (for the purpose of this Release and Waiver, "Tae Kwon Do Activities" shall include any and all actives related or incidental to the operations of the Releases I AM AWARE THAT, in addition to the usual dangers and risks inherent in the Tae Kwon Do Activities there are certain additional dangers and risks involved in such activities resulting in particular from sparring activities and the contact between Tae Kwon Do participants including, without limitations, serious cuts, bone fractures, sprains or strains, and head, face, and body injuries and I agree to assume and do hereby accept all risks of the Tae Kwon Do Activities and the possibility of personal injury, death, property damage, or other loss resulting therefore. IN ENTERING INTO this Release of all Claims and Waiver of Liability Agreement, I am not relying upon any oral or written representations or statements made by the School or any of its directors, officers, employees, representatives or agents, including those in any "handouts" or "brochures", to induce me to undertake the Tae Kwon Do Activities. I CONFIRM THAT I have read and understand this Release of all Claims and Waiver of Liability Agreement prior to signing it and agree that this Agreement will be binding upon myself, my heirs, personal representatives, executors, successors, administrators and assigns and whomsoever else may have an interest either at common law or by operation of
Signature*

Clear
Name*
Credit Card Authorization Form
Today's Date
Cardholder Name
Expiration Date
I authorize
to charge the agreed amount listed above to

My credit card provided herein. I agree that I will pay for this purchase in accordance with the issuing bank cardholder agreement.

**Your card must be present for the first day of camp as we will be charging your card on the day of the Camp.
Signed

Clear
Dated

MonthDayYear
Date
Pricing:
Week 1: July 8-12, 2024

Early Bird (till 5/31/24): $280 + taxLate Registration: $300+ taxDrop-in (per day): $70 + tax
Week 2: July 22-26, 2024

Early Bird (till 5/31/24): $280 + taxLate Registration: $300+ taxDrop-in (per day): $70 + tax
Week 3: August 12-16, 2024

Early Bird (till 5/31/24): $280 + taxLate Registration: $300+ taxDrop-in (per day): $70 + tax
Week 4: August 19-23, 2024

Early Bird (till 5/31/24): $280 + taxLate Registration: $300+ taxDrop-in (per day): $70 + tax
*Second child receives 15% off their registration fee

Please note that for ALL camps we will only be running if we have at least 5 confirmed attendees.
Should be Empty:

Evolve Martial Arts Summer Camp

Permission to Ride Form

Registration Form

PARENT / GUARDIAN Information:

Emergency Contact Information:

NAME AND PHONE NUMBER(S) OF PERSON(S) OTHER THAN PARENTS ALLOWED TO PICK UP YOUR CHILD

MEDICAL RELEASE FORM

Pricing: