Kids Jiu Jitsu Summer Camp Registration & Waiver
Register your child for American Top Team Sandy Springs Kids Jiu Jitsu Summer Camp (June 15–19, Ages 4–13). Complete all sections, including legal waivers and authorizations.
Child Information
Please provide details about the child attending camp.
Child’s Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Age
*
Belt Level (if applicable)
T-Shirt Size
Please Select
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Other
Parent / Guardian Information
Contact details for parent or legal guardian.
Parent/Guardian Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Emergency Contact Name
*
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Medical & Allergy Information
Please provide relevant medical and allergy information.
Medical conditions (if any)
Food allergies or dietary restrictions (if any)
Medications currently taken (if any)
Drop-Off & Pick-Up Authorization
List all persons authorized to pick up your child and any special instructions.
Authorized pick-up person(s)
Special instructions or early pick-up notes
Photo & Video Release
Please select your preference regarding photo and video usage for gym marketing.
Do you give permission for your child’s photo/video to be used for gym marketing?
*
I give permission for my child’s photo/video to be used for gym marketing
I do NOT give permission
Assumption of Risk, Release of Liability, Medical Authorization, and Behavior Policy
Please read and acknowledge the waiver and policies below.
By checking this box, I acknowledge and agree to the Assumption of Risk, Release of Liability, Medical Authorization, and Behavior & Removal Policy as described above.
*
I have read and agree to the terms and conditions stated above.
Parent/Guardian Full Name (Printed)
*
First Name
Last Name
Signature (Required)
*
Date Signed
*
-
Month
-
Day
Year
Date
Submit Registration
Submit Registration
Should be Empty: