Seven Star Dragons HPS Karate 2018 Sign-Up Sheet
This is the sign-up sheet for Hyde Park School's Seven Star Dragons Karate Classes.
Seven Star Dragons: HPS Karate at the Hyde Park School Dojo
Name of Parent or Guardian (Last, First) *
Your answer
Name of Student Enrolling in Class (Last, First) *
Your answer
Age of Student *
Your answer
School Room Number of Student *
Your answer
Grade Student Is In *
Mailing Address *
Your answer
Zip Code *
Your answer
E-mail Address *
Your answer
Phone Number (XXX) XXX-XXXX *
Your answer
Please Choose Which Classes Your Student Will Be Attending. Pay careful attention so that your child is enrolled in the proper classes. *
Required
Emergency Contact Name & Phone Number (if different from parent/guardian)
Your answer
Does the student have any physical or medical conditions that the instructor should be made aware of? If yes, please explain (e.g. asthma, allergies). If no, type "none." *
Your answer
Dismissal: Where will your child go after class? *
Please list parents/guardians (including phone number) with permission to pick up your child if not already provided. *
Your answer
Uniforms & Equipment
Uniforms are not included in the tuition fees, but team uniforms and gear will be made available for purchase through the instructor. A limited amount of loaner equipment (sparring pads/helmet, practice, etc.) will made available, but supplies are limited. Second year students can purchase their own team sparring gear and bo staff. Donations to purchase additional loaner equipment are always greatly appreciated! Please speak to the instructor about making a contribution if you are able to do so.
Payments & Sessions
You agree to pay in full, the amount of $130 per session. SESSION 2 runs from Sept. 24, 2018 through Dec. 3, 2018..

Class sizes are limited! Please visit our website (link below) for online payments to reserve your spot in class.

http://7stardragonskarate.com/index.php/hyde-park-school-dojo/

I have read and understand the Payments & Sessions terms. *
Required
HPS Karate Agreement
I do hereby voluntarily submit my application for participation in the Hyde Park Karate Program, and I do assume all risk of personal injury including all losses which I may incur by my participation. Acting for myself, my heirs and my assigned, I do hereby release all claims against persons connected with Terrell Davis, 7 Star Dragons Karate, Hyde Park School, HPSPTO, CPS, Volunteers, or any of it"s employees from any and all liabilities . I understand this is a voluntary activity of which I am fit to participate in. I hereby grant permission for the use of photos and video while in program to be used on social media (e.g. Seven Star Dragons Facebook pages), 7stardragonskarate.com website, and correspondence to update families. I understand there is a $35 return check fee. There are no refunds after the first class.

Please download the HPS Karate Agreement at the following link, sign it, and bring it to class: http://goo.gl/xfPGva

I have read and understood the HPS Karate Agreement. *
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