Camper Information

First Name*

Last Name*

Gender*

MaleFemaleOther

Date Of Birth*

Email*

Phone Number*

Address*

Address Line 1*

Address Line 2

City*

State or Region*

Country*

Zip*

Grade Level:*

School Name:*

Parent/Guardian Full Name:*

Relationship to Camper:*

Parent's Phone Number:*

Camp Session Information

Which camp session are you registering for?*

Session 1: June 5 - June 19Session 2: July 10 - July 24Session 3: August 7 - August 21

Camp Time Preference:*

Morning (9 AM - 12 PM)Afternoon (1 PM - 4 PM)Full Day (9 AM - 4 PM)

Has your child ever practiced martial arts before?*

YesNo

What are your child’s goals for attending Martial Arts Camp?*

Does your child have a favorite martial arts technique or skill they would like to focus on?*

What are your child’s goals for attending Martial Arts Camp?*

Does your child enjoy working in group activities or prefer working independently?*

GroupIndependentBoth

please describe the medical condition or allergy and any required precautions:

Terms and Conditions*

I give permission for my child to participate in all activities during the Martial Arts Camp, including physical sparring and self-defense practice.I give consent for my child’s photos/videos to be taken during camp activities and used for promotional purposes.I understand that my child will be supervised during all camp activities and that reasonable safety precautions will be taken.

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