2024-2025 OMAC Waterdown After School Registration Form

OMAC Waterdown

After School Program 2024 - 2025

Basic CareExtended Care

Student Name*

First NameMiddle NameLast Name

Birth Date*

MonthDayYear

MaleFemale

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Legal Guardian Information

Name*

First NameLast Name

Phone Number*

Format: (000) 000-0000.

Parent/Guardian E-mail*

example@example.com

Parent/Legal Guardian Information

Name*

First NameLast Name

Phone Number*

Format: (000) 000-0000.

Parent/Guardian E-mail*

example@example.com

Other Emergency Contact (Different From Parent/Legal Guardian)

Name*

First NameLast Name

Phone Number*

Format: (000) 000-0000.

Relationship to Child*

YesNo

School Information

Child's School*

Anyone Selecting "Other" must contact the school directly (Might not service your school)

If Other, Please Type In Your Desired School

School's Dismissal Time*

Child's School Grade*

Program Start Date*

Yes, regular booster seat.No

Please specify pick-up days needed. (For example, Monday, Wednesday, Thursday, Friday and NOT Tuesday, or all five days Monday - Friday).*

Medical Information

Notice to Parents and Legal Guardians

OMAC’s after-school program offers your children with the opportunity to gain valuable skills in various martial arts and is considered exempt from child care licensing requirements otherwise required under the Ontario Child Care and Early Years Act, 2014 (the Act).

OMAC’s after-school program is considered as an “authorized recreational and skill building program” under the Act. As an authorized recreational and skill building program, OMAC must ensure that the following requirements are adhered to:
•       We place an emphasis on martial arts training and other recreation as part of programming;
•       We only accept enrollments for students who are at least four years of age or who will turn four years of age during the calendar year in which they first enroll; and
•       The after-school program will be operated on weekdays for no more than one period of three or fewer consecutive hours each day.

It is also a requirement under the Act that OMAC provide each parent with a written disclosure that OMAC’s after-school program is not a licensed Child Care program. The Government of Ontario does not license this Child Care program.

We ask that you please confirm receipt of this notice.

Doctor's Name:*

Office Number:*

Format: (000) 000-0000.

Ontario Health Card #:*

YesNo

Please list any allergies, medical conditions and medications that requires OMAC staff awareness.*

Emergency Consent

It is our policy to notify a parent when a child is ill or needs medical attention. Occasionally, we cannot contact a parent and need to get immediate help for your child. Our procedure is to take your child to the nearest emergency service. Please sign below so that we can take appropriate action on behalf of your child.
I HEREBY GIVE MY/OUR CONSENT FOR MY/OUR Student's Full Name WHEN ILL/INJURED, TO BE TAKEN TO THE NEAREST EMERGENCY CENTER BY OMAC STAFF WHEN I/WE CANNOT BE CONTACTED. I CONSENT TO AN AMBULANCE BEING CALLED TO TRANSPORT THE CHILD, IF NECESSARY. I FURTHER AGREE TO PAY ALL COSTS INCURRED FOR TRANSPORT.

Student Absences

It is our policy that the parent of each child is to notify an OMAC Representative when their child will NOT need pickup. Should your child be absent from school or not need to be picked up by the After School program, OMAC must be notified by phone, no later than 2:00pm. In the event the phone is not answered, we ask that a message be left with the date of the absence, your child’s full name and the school they attend.

After School Payment Plan

For New Students Only: The deposit and one time REGISTRATION FEE payment is $149. This fee is mandatory and includes reservation of spot in program and an OMAC Uniform.

OMAC After School monthly tuition will be withdrawn of the first of each month from September 2024 through to June 2025.

Note about this form: your credit card information will not be saved on this form, it will be used to pay for the Registration Fee ONLY. An OMAC representative will contact you directly to receive your payment information for the membership tuition.

Credit Card (OMAC will be in contact for this information)Pre-authorized payment via Void Cheque (OMAC will be in contact for this information)

As parent or guardian, I agree to the above Payment Plan and to pay all tuition fees when due.*

Parent/Legal Guardian (Signature)

Date*

Date

Cancellation Policy

I hereby submit my application for registration with OMAC WORLD CLASS MARTIAL ARTS. I understand that the After School Program requires a commitment for the entire school year. I understand that a 30-day notice of cancellation prior to final payement for the After School Program will be required. After the 30-day notice period, a cancellation fee of $149+hst will be applied. Any tuition payment made prior to the 30-day cancellation notice will not be refunded. A person may transfer between OMAC programs after the 30-day notice period to avoid the cancellation fee. Following the 30-day notice period and payment of the cancellation fee, all other tuition fees will be terminated. I understand that any contract paid in full at the time of registration is 100% non-refundable. All Memberships are transferable to immediate family members. This agreement shall not renew automatically and is the responsibility of the [Signee] to commence a new contact should they wish to continue services with OMAC WORLD CLASS MARTIAL ARTS. I understand that this is a full-time afterschool program operating for the full school year and therein requires tuition payable to OMAC World Class Martial Arts to be paid each month in full regardless of time taken off for vacation/trips of any kind. NOTE: Students must stay home to quarantine due to being sick.

I agree and understand to the cancellation policy and that OMAC's after school program is considered as an authorized recreational and skill building program. Parent/Legal Guardian Full Name* Date*