Karate
$60 (k-8)

3-4pm on Mondays in the Gym
January 22, 29
February 5, 12, 26
March 5, 12, 19, 26

Please send a check for the fee to the school in an envelope marked with your student's name, homeroom, and activity.

Student's Name *
Your answer
Homeroom *
Does your child have any allergies or take medications?
Your answer
Does your child have a medical condition? *
If yes, please describe. *
Your answer
Transportation Arrangements *
If being picked up, will be picked up by
Your answer
Parent's Name *
Your answer
Parent's Email Address *
Your answer
Waiver
I hereby agree, on behalf of the named student and his/her other parent or legal guardian to waive any claims for liability against the school, The Diocese of Harrisburg (and any diocesan or school officer, agent or employee) which may arise from the participation of the named student in this activity.

I understand that by entering my initials below, I am signing this waiver electronically and giving consent for my student to participate.

Parent's Initials *
Your answer
Today's Date *
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