Summer Camp Registration Form

Summer Camp Registration
Student Information
Student's Name

First NameLast Name
Birth Date

MonthDayYear
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Registration
prevnext( X )
Weekly RegistrationPrice per week
$275.00CAD Quantity



4 Week RegistrationPrice for 4 weeks
$1,000.00CAD



8 Week RegistrationPrice for 8 weeks
$1,680.00CAD



Total

$0.00CAD
Specific Dates

June 23, 2025 - June 27, 2025June 30, 2025 - July 4, 2025July 7, 2025 - July 11, 2025July 14, 2025 - July 18, 2025July 21, 2025 - July 25, 2025July 28, 2025 - Aug 01, 2025Aug 04, 2025 - Aug 08, 2025Aug 11, 2025 - Aug 15, 2025
Parent/Guardian Information
Name

First NameLast Name
Cell Number
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Does the student have any allergies, medical conditions, or require an inhaler? If yes, please provide details.
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by KIM TAEKWONDO (DIVISION OF 2426-4863 QUEBEC INC.) during the selected camp. In exchange for the acceptance of said child’s candidacy by KIM TAEKWONDO (DIVISION OF 2426-4863 QUEBEC INC.), I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless KIM TAEKWONDO (DIVISION OF 2426-4863 QUEBEC INC.). and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against KIM TAEKWONDO (DIVISION OF 2426-4863 QUEBEC INC.). including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including Taekwondo. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
Refund policy

1. Deposit:
A non-refundable deposit is required upon registration to secure a spot for the camper in the summer camp program. This deposit will be applied towards the total camp fees.

2. Cancellation:
In the event of cancellation by the camper or their parent/guardian, the deposit made is non-refundable. No refunds will be issued for the deposit amount, regardless of the reason for cancellation.

By submitting the deposit, the student and their parent/guardian acknowledge and agree to abide by the refund policy outlined above.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Signature

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Summer Camp Registration

Student Information