슬라이드 1 - Yong In Martial Arts

Report
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Yong-in Track out Camp Enrollment Form 2015
Student’s Name :_____________________________ Age : _____
Student’s Name :_____________________________ Age : _____
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Student’s Name :_____________________________ Age : _____
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Home Phone :___________________ Cell phone:_______________________ E-mail:___________________________________________________
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Emergency contact Name :_____________ Phone :____________________
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The following people have permission to pick up my child
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Name :___________________________ Relationship to child :____________
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Please list any allergies or medical conditions that pertain to your child. :________________________________________________________________
2015 Fees for regular hours (8:00 a.m – 5:00 p.m) *( ) is non-member price.
1Day$40($45) 2Days $80($85) 3Days$110($120) 4Days$135($155) 5Days $149($169)
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Registration Fee : $29 (1 time required)
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Early drop off 7:00 am–8:00am $20 additional per week per child (or $7 per time) /Late pick up 5:00pm–6:00pm $20 additional per week per child (or $7 per time)
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10% discount for additional family members, All field trip fee is included.
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Half day (8:00am – 12:30pm) camp price : 30% off
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Yong-in T-shirts required everyday. A Snack, Lunch required everyday.
Please write enrolled date : (Traditional/ Track 1 , 2 , 3 , 4 ) _______________________
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Please initial each item below:
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______I understand that the camp open with minimum 5 child, maximum 20 child.
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______I understand that sick or any other reason, there will be No make up for days absent, no exceptions!
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______I understand that in the event of an emergency, I give permission of Yong-in to secure immediate medical attention and
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treatment should I not be able to be reached. I agree to be financially responsible for any costs incurred.
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______I understand that Yong-in take pictures my child for camp purposes.
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______I understand that child must follow our 3 basic rules(Safety, Respect director, Respect property).
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______I understand that cancelation/refund policy
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1) $29 Registration fee is not refundable or transferable at any time unless it is a medical reason (must have written explanation from Doctor).
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2) If you cancel with more than 30 days till the session start date, then you will receive all money paid EXCEPT $29 refund
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3)15-30 days until the session start date, 50% refund
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4)1weeks prior to start of camp session = NO REFUND
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Total amount $__________________ Pay amount $____________________ Balance amount $_______________
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Print Name _______________________________ Signature___________________
Date ___________________

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