• Afterschool Child Enrichment Program Registration Form

    Afterschool Child Enrichment Program Registration Form

    Please fill out the form carefully for registration
  • Format: (000) 000-0000.
  • Permissions:
  • Acknowledgement: I understand pick up is by 6:00 PM. Each minute after 6:05 PM will be $10/minute*
  • Acknowledgement: I understand that as a martial arts gym, physical punishment (push ups, burpees, etc) is used for disrespect*
  • Acknowledgement: I understand that due to a wait list, the terms of this agreement are per semester.*
  • I authorize autopay*
  • VALLEY MARTIAL ARTS, LLC

    AFTER-SCHOOL PROGRAM ENROLLMENT AGREEMENT

    3501 Erie Canal Rd. • Terre Haute, Indiana 47802

    This After-School Program Enrollment Agreement (“Agreement”) is entered into between Valley Martial Arts, LLC (“VMA”) and the Parent(s)/Legal Guardian(s) (“Parent”) of the enrolled child (“Student”). By signing this Agreement, Parent acknowledges that they have read, understood, and agree to all terms and conditions contained herein.

     


    1. PROGRAM ENROLLMENT

    Enrollment in the Valley Martial Arts After-School Program reserves a space exclusively for the Student for the duration of the selected semester.

    Enrollment is not guaranteed until this Agreement has been signed and all required registration fees and tuition payments have been received.

    VMA reserves the right to deny or terminate enrollment at its sole discretion for violations of this Agreement or for conduct that threatens the safety, welfare, or operation of the program.

     


    2. TERM OF AGREEMENT

    This Agreement is for one academic semester. Semester is defined as August-December and January-May.

    A semester begins on the first scheduled day of attendance and concludes on the final scheduled day of that semester unless terminated according to the terms of this Agreement.

    Enrollment is a contractual commitment for the entire semester.

     


    3. TUITION AND PAYMENT TERMS

    Parent agrees to pay the full semester tuition regardless of attendance.

    Tuition reserves the Student’s position in the program and is not based upon the number of days attended.

    No refunds, credits, or reductions in tuition shall be granted for:

    ● Illness

    ● Vacation

    ● School closures

    ● Absences

    ● Suspensions

    ● Personal scheduling conflicts

    ● Inclement weather beyond VMA’s control

    Returned payments shall be subject to a $35 returned payment fee plus any bank charges incurred by VMA.

    Accounts more than fifteen (15) days delinquent may result in suspension or termination of services.

     


    4. EARLY WITHDRAWAL

    Because enrollment is limited and VMA maintains a waiting list, Parent acknowledges that enrollment prevents another family from occupying the Student’s reserved space.

    If Parent withdraws the Student before completion of the semester for any reason other than:

    ● permanent disability,

    ● military relocation,

    ● relocation more than fifty (50) miles from Terre Haute,

    ● or another reason approved in writing by VMA,

    Parent remains financially responsible for all tuition owed through the end of the semester.

    Parent agrees this obligation represents a reasonable estimate of damages suffered by VMA due to the inability to immediately replace the reserved position and is not intended as a penalty.

    VMA may pursue all lawful remedies available under Indiana law to recover unpaid tuition, including court costs, collection costs, reasonable attorney’s fees where permitted by law, and applicable interest.

     


    5. WAITLIST ACKNOWLEDGMENT

    Parent understands:

    ● Enrollment spaces are limited.

    ● Acceptance reserves one exclusive space.

    ● Other applicants may be denied admission because of this reservation.

    ● Early withdrawal causes financial harm to VMA.

    Parent agrees that semester tuition is earned by reserving the student’s position and staffing the program.

     


    6. TRANSPORTATION AUTHORIZATION

    Parent authorizes Valley Martial Arts, LLC to transport the Student between the Student’s school and Valley Martial Arts.

    Transportation may be provided by employees, instructors, volunteers, contractors, or other authorized drivers selected by VMA.

    Parent certifies the Student may ride in passenger vehicles operated for program transportation.

     


    7. TRANSPORTATION RELEASE OF LIABILITY

    Parent understands transportation by motor vehicle involves inherent risks including but not limited to:

    ● Motor vehicle accidents

    ● Weather conditions

    ● Traffic delays

    ● Mechanical failures

    ● Negligence of third-party motorists

    ● Road hazards

    ● Unexpected emergencies

    Parent voluntarily assumes these risks.

    Except in cases of gross negligence, willful misconduct, or where prohibited by Indiana law, Parent releases and holds harmless Valley Martial Arts, LLC, Cody Strain, Courtney Strain, instructors, employees, volunteers, authorized drivers, landlords, contractors, successors, and assigns from any claims arising from transportation provided by VMA.

     


    8. AFTER-SCHOOL PROGRAM ASSUMPTION OF RISK

    Parent understands participation includes:

    ● Martial arts instruction

    ● Indoor recreation

    ● Outdoor recreation

    ● Homework assistance

    ● Games

    ● Crafts

    ● Playground activities

    ● Fitness activities

    ● Snacks

    ● Walking between activities

    ● Transportation

    Despite reasonable supervision, accidents can occur.

    Parent voluntarily assumes all risks associated with participation.

     


    9. GENERAL RELEASE OF LIABILITY

    Except where prohibited by law or caused by gross negligence or intentional misconduct, Parent releases Valley Martial Arts, LLC, its owners, instructors, employees, volunteers, contractors, landlords, affiliates, successors, and assigns from all liability arising out of participation in the After-School Program, including but not limited to:

    ● Personal injury

    ● Illness

    ● Property damage

    ● Allergic reactions

    ● Emotional distress

    ● Accidental injury

    ● Death

    This release applies whether occurring on VMA property, during transportation, during field trips, or while participating in program activities.

     


    10. MEDICAL AUTHORIZATION

    If Parent cannot be reached during an emergency, Parent authorizes VMA personnel to secure emergency medical treatment for the Student.

    Parent accepts full financial responsibility for all emergency medical expenses incurred.

    Parent agrees to maintain current emergency contact information at all times.

     


    11. MEDICATION

    Prescription medications will only be administered when:

    ● Medication is in the original prescription container.

    ● Written parental authorization has been provided.

    ● Written physician instructions accompany the medication if required by law.

    VMA reserves the right to refuse administration of medication.

     


    12. PICK-UP POLICY

    Regular pickup is no later than 6:00 PM.

    Late pickup fees shall be:

    ● $10.00 per minute beginning five (5) minutes after 6pm.

    Repeated late pickups may result in immediate dismissal from the program.

    Only authorized individuals listed by Parent may pick up the Student.

    Government-issued identification may be required.

     


    13. BEHAVIOR POLICY

    Students are expected to:

    ● Show respect.

    ● Follow staff directions.

    ● Refrain from bullying.

    ● Refrain from fighting.

    ● Use appropriate language.

    ● Respect property.

    VMA reserves the right to suspend or permanently dismiss any Student for conduct deemed unsafe, disruptive, abusive, or inconsistent with program expectations.

    Dismissal does not relieve Parent of semester tuition obligations.

     


    14. PERSONAL PROPERTY

    VMA is not responsible for lost, stolen, or damaged personal property.

    Students are discouraged from bringing valuable items.

     


    15. PHOTO AND VIDEO RELEASE

    Unless Parent opts out in writing, Parent grants permission for photographs and video recordings of the Student to be used for:

    ● Marketing

    ● Social media

    ● Advertising

    ● Website content

    ● Printed materials

    No compensation shall be due.

     


    16. FORCE MAJEURE

    VMA shall not be liable for interruptions caused by:

    ● Weather

    ● Acts of God

    ● Government action

    ● Pandemics

    ● Utility failures

    ● Civil emergencies

    ● Circumstances beyond VMA’s reasonable control

    VMA may provide alternate programming or schedule adjustments when practical.

     


    17. GOVERNING LAW

    This Agreement shall be governed by the laws of the State of Indiana.

    Venue for all disputes shall lie exclusively in the state courts located in Vigo County, Indiana, unless otherwise required by law.

     


    18. ATTORNEY’S FEES

    To the extent permitted by Indiana law, the prevailing party in any action arising under this Agreement shall be entitled to recover reasonable attorney’s fees, court costs, and litigation expenses.

     


    19. SEVERABILITY

    If any provision of this Agreement is determined to be invalid or unenforceable, all remaining provisions shall remain in full force and effect.

     


    20. ENTIRE AGREEMENT

    This Agreement constitutes the entire understanding between the parties concerning the After-School Program.

    No verbal representations shall modify this Agreement.

    Any amendment must be made in writing and signed by both parties.

     


    PARENT ACKNOWLEDGMENT

    By signing below, Parent acknowledges that:

    ● They have carefully read this Agreement.

    ● They understand the legal rights being waived.

    ● They voluntarily agree to all terms.

    ● They understand this Agreement is legally binding upon themselves, their heirs, successors, and assigns.
     
     

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