2021 Spring Break & Summer Camp Registration

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. List the name of at least two person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of the studio/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18.
Emergency Contact & Authorized Pick-Up #1
Full Name*

First NameLast Name
Primary Phone Number*
Format: (000) 000-0000.
Secondary Phone Number
Format: (000) 000-0000.
Relationship to Child*
Emergency Contact & Authorized Pick-Up #2
Full Name*

First NameLast Name
Primary Phone Number*
Format: (000) 000-0000.
Secondary Phone Number
Format: (000) 000-0000.
Relationship to Child*
Authorized Pick-Up #3
Full Name

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
Authorized Pick-Up #4
Full Name

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
Authorized Pick-Up #5
Full Name

First NameLast Name
Primary Phone Number
Format: (000) 000-0000.
LATE PICK UP POLICY: Parents of participants enrolled in Camp at Karate International San Antonio will be charged $1.00 per minute per child starting at 5:31pm. If you are going to be late please notify Karate International so we can let your child(ren) and the camp counselors know. Late fees will still be charged. If a parent or authorized pick-up person does not arrive or call by 15 minutes past the designated pick-up time of 5:30pm, staff will assume an emergency exists and will begin to call emergency contacts for your child(ren) to arrange pick-up. If no emergency contact can be reached within 1-hour past designated pick-up time, staff may contact the San Antonio Police Department who will pick up the child(ren). Late pick-up fees will be due within two business days. Late pick-up fees can be paid to the Summer Camp Director upon pick up. Continued disregard for the pick-up time or failure to pay late pick-up fees can be cause for the child(ren)'s termination from the program. If termination is necessary due to continued disregard of pick-up policy Karate International will not issue any refunds .*
Type initials above to consent
AUTHORIZED PICK UP POLICY: Only the people listed above may pick up your child from camp. No exceptions are made for family members without advanced written notice prior to pick up.*
Type initials above to consent
Please provide the names of persons who are UNAUTHORIZED to pick up your child: (These people are specifically NOT allowed to pick up your camper)
List the FIRST and LAST names of all persons unauthorized to pick up your child.

Sunscreen & Lotion Policy

Karate International staff will assist in applying sunscreen and/or lotion to children attending camp. I (parent or guardian) understand that this may require the staff member to touch my child's face, shoulders, back, arms, and lower legs. Sunscreen and/or lotion will be applied in the presence of other staff members. I understand that staff will not apply sunscreen/lotion to any child's front torso or upper legs, but will assist and/or direct the child to do so. I understand that no Karate International staff member will be allowed to apply any sunscreen, lotion or ointment to any area that would be covered by a bathing suit for any reason. In the event that any child does not bring sunscreen to activities/camp and conditions warrant it's use, members of Karate International staff will use camp supplies to apply sunscreen as described above.
- Each child's parent/guadian must sign authorization for use and application of sunscreen/lotion on thier child(ren)
- Sunscreen and/or lotion containers must be labeled with the child's full name and must be provided to staff upon check-in.
- Children should, in most instances, apply the sunscreen/lotion on thier own or come to Epic Martial Arts activities with sunscreen/lotion already applied before arrival. If assistance is needed it will be provided by staff ONLY if specifically authorized (see above).
Agree and give permission to applyDO NOT give permission for staff to apply
I GIVE PERMISSION for Karate International staff to administer sunscreen/lotion to my child(ren). I have read Karate International policies regarding the administration of sunscreen/lotion and agree to comply. I understand that Epic Martial Arts is not responsible for non-compliance by my child. I further acknowledge that Karate International, it's directors, officers, agents, employees, and staff shall have immunity from any liability from damages, injuries, allergies, or reactions resulting from the administration of the sunscreen and/or lotion provided.*
Type initials above to consent
I DO NOT GIVE PERMISSION for Karate International, it's directors, officers, agents, employees, and staff to assist in applying sunscreen to my child(ren). I further agree to take FULL responsibility to apply sunscreen/lotion prior to arrival of all Karate International and/or camps. I relieve Karate International, it's management, owners, assigned staff, officers, agents and employees from any liability resulting from not applying sunscreen and/or lotion.*
Type initials above to consent

Pricing, Payment, Policies & Procedures

Karate International San Antonio is referred to as "KISA"
Summer Camp RATES: (Week 1-June 10th-15th, Week 2- June 17th-21st, Week 3-June 24th-28th, Week 4-July 8th-12th, Week 5- July 15th-19th, Week 6- July 22nd-26th, Week 6-July 29th-August 2nd, Week 7- August5th-9th, Week 8- August 12th-16th )- $275 per week. This rate is for Summer Camp only and cannot be transferred or used towards any other events, classes, or merchandise offered by Karate International San Antonio should your plans change. A $50 deposit is required per week to reserve your child's spot for Summer Camp. Deposits paid will go towards weekly camp rate. and a payment plan will be set up for the remaining camp balance unless other arrangements have been made with the summer camp director.*
Type initials above to consent
CAMP HOURS: 9:00am-3:00pm. Free Extended Hours 7:30am-9:00am & 3:00pm-5:30pm.*
Type initials above to consent
FOOD AND SNACKS: I acknowledge that KISA will not provide food and snacks during the camp, and it is my responsibility to send my child each day with lunch, two snacks and water bottle.*
Type initials above to consent
MINIMUM AGE: I acknowledge that my child will be at least 4 years of age on the first day of camp he or she attends.*
Type initials above to consent
WAVIER & RELEASE: Buyer(s) understands that Student(s) is engaging in physical activity, along with the use of KISA’s facilities, equipment, training and instruction, which can be dangerous and could cause injury. Therefore Buyer(s) assumes all risk of injury to said Student(s). Buyer(s) / Student(s) hereby waives and releases any claim or right to sue KISA, its employees or agents for injury. Buyer(s) has carefully read this waiver & release and fully understands that it releases KISA of all liabilities for any injury that may occur. It is always advisable to consult your physician before undertaking a physical activity program, particularly those performed at KISA. Additionally, I hereby grant and authorize KISA the right to take, edit, copy, publish, distribute and make use of any and all photos or video taken of my child(ren) to be used in and/or for legally promotional materials and digital communications. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing. I understand and agree that these materials shall become the property of and will not be returned.*
Type initials above to consent
LOSS/DAMAGE/THEFT: KISA does not assume any responsibility for the loss, damage, or theft of any property belonging to the Buyer(s)/Student(s) and I agree by initialing above that KISA and its personnel are not responsible or liable for any such property in the event of loss, damage, or theft on or about the facility.*
Type initials above to consent
TRANSPORTATION RELEASE: I (parent or guardian) give my consent to KISA, its officers, agents, employees, individuals associated with the organization to transport my child(ren) named above to and from the authorized activities and events.*
Type initials above to consent
EMERGENCY MEDICAL: I (Parent or Guardian) give my consent to Karate International San Antonio, its officers, agents, employees, individuals associated with the organization or any emergency medical personnel to administer necessary treatment to my child (named above) in the event of an emergency and authorize transportation for child by ambulance if situation warrants. I agree to assume responsibility for the payment of the emergency treatment.*
Type initials above to consent
SICK POLICY: Campers, students, family members, guests, and vistors with fever, cough, sore throat or other flu-like symptoms are not permitted until they have completed a 5 day self-quarantine. People who have traveled to a high-risk area for COVID-19 are not permitted or had contact with a person known to be infected with COVID-19 are not permitted until they have completed a 5 day self-quarantine. Any camper with a fever above 100.4 will not be permitted and will be required to be pick-up immediately. *
Type initials above to consent
COVID-19: I (Parent or Guardian) understand that Karate International has implemented steps and procedures to reduce the risk and spread of COVID-19 in accordance with state and federal guidelines. However, due to the nature of the novel coronavirus, KISA cannot guarantee any visitor, guest, student or camper entering our facility will not be potentially at risk. By entering our facility, you hereby assume full responsibility and waive all claims against Karate International San Antonio, its owners, staff, instructors, partners or otherwise, for any and all injuries, claims, medical expenses or damages.*
Type initials above to consent
*Trade In Stock: I UNDERSTAND THAT KISA IS A MARTIAL ARTS SCHOOL AND NOT A DAYCARE IN AS SUCH, THEIR STOCK-IN-TRADE IS NOT SUPERVISION AND CARE. THE SUPERVISION AND CARE OF MY CHILD(REN) IS INCIDENTAL TO THEIR PARTICIPATING IN THE PROGRAM AND THAT KISA MARTIAL ARTS IS NOT ASSUMING RESPONSIBILITY OR THE PROVISION OF DAILY CHILD CARE OUTSIDE OF THE PROGRAM. THE INTENT OF KISA IS TO TEACH MARTIAL ARTS PHYSICAL AND PHILOSOPHICAL CHARACTER BUILDING SKILLS.*
Type initials above to consent
DISCIPLINE POLICY: In an effort to provide your child and other students with a safe and fun experience, it is necessary that all students exhibit proper behavior, self-discipline and self-control. Correcting unsatisfactory behavior is time consuming and distracts from providing quality, safe, educational, and fun activities for the rest of the students. If we are unable to control a situation, we will contact the parents first by telephone at or near the disturbance, so that the parent may reinforce (by phone) the requirement that all students enrolled in the summer camp program behave satisfactory and follow instructions fully and promptly. Students that cannot be controlled by verbal commands or that are a constant disciplinary problem will be suspended from the program(s).*
Type initials above to consent
CANCELLATIONS, REFUNDS & ABSENCES: We understand plans change. KISA will gladly issue a refund (minus the required $50 deposit) for any cancellation request received in writing more than 14 days before the scheduled session date. No refunds, credits, or transfers are available for sick days or absences for any reason. This includes but is not limited to transferring the amount paid to classes, merchandise, or other events offered by Karate International San Antonio.*
Type initials above to consent
Sign Document*
Date Signed*

MonthDayYear
Special notes or direction for staff members:
Example: "Please add us to the wist list for weeks ________."
Should be Empty:

2025 Camp Registration

KISA offers camp for children ages 5-13!

Below are the 2025 Camp Dates

ATTENTION: Camp weeks are being restricted to limited capacity. If you need to change a week or have additional questions, please call us at (210) 585-3433.

Camper's Information

Parent Information

Emergency Contacts/Authorized Pickup

Medical / Health Information

Medication

Sunscreen & Lotion Policy

Pricing, Payment, Policies & Procedures