UMA Summer Camp Registration

UMA Summer Camp Registration

Register for Universal Martial Arts' summer camp. Please provide camper, parent/guardian, emergency, and payment information. Complete required waivers and consent.
Student Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender

MaleFemaleOther
Parent/Guardian Contact Information
Parent/Guardian Full Name*

First NameLast Name
Relationship to Camper
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Emergency Contacts
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Medical Information
Does the child have any allergies?

NoYes
Please specify allergies (if any)
Medical Conditions or Medications
Camp Session Selection
Select Camp Session*

Session 1: June 10-14Session 2: July 15-19Session 3: August 5-9
Tuition Payment
Camp Tuition Payment — $675 per session*
prevnext( X )
Single Session Tuition
Covers one camp session for one camper.

$150.00 Session

Multiple Sessions Package
Enroll in any two sessions and save.

$270.00 Sessions

Total

$0.00
Waivers and Consent
Liability Waiver
I acknowledge and accept all risks associated with participation in the Universal Martial Arts Taekwondo Summer Camp. I release Universal Martial Arts and its staff from liability for any injury or loss incurred during camp activities.
Photo/Video Release
I authorize Universal Martial Arts to photograph or video my child during camp activities for promotional purposes.
Medical Treatment Authorization
I authorize Universal Martial Arts staff to seek emergency medical treatment for my child if necessary.
Parent/Guardian Signature*
Date Signed*

MonthDayYear
Date
Should be Empty:

UMA Summer Camp Registration

Parent/Guardian Contact Information

Emergency Contacts

Medical Information

Camp Session Selection

Tuition Payment

Waivers and Consent