Summer Sports and Fitness Camp

2014 Schedule

Hours: 9:30 - 3:00 Mon - Fri.
*Students have the option of attending a whole weeks, or partial weeks.
Week #1: June 16-20 Week #5: July 14-18 Week #9: August 11-15
Week #2: June 23-27 Week #6: July 21-25 Week #10: August 18-22
Week #3: June 30 - 7/3 Week #7: July 28 - 8/1 Week #11: August 25-29
Week #4: July 7-11 Week #8: August 4-8 Back to School



2014 Summer camp Application
International Tae Kwon Do Academy
32 Tioga Way Marblehead, MA. (781) 631-8504 / www.tkd.net


Name _______________________________________________________ Date of birth ____/____/____

Address ____________________________________City_________________________________________

Phone #s _____(________)_______________________     ______(_________)_________________________

General Health: (please check) Excellent _______ Good _______ Fair _______ Poor________

Are you Allergic to bees? Yes ___ No ___ Donít Know ___ (If yes, please bring a bee sting kit.)

Any medical problems? Yes ___ No ___ Are you taking medications? Yes ____ No ____

If yes, then please explain? _______________________________________________________________

The above named student would like to enroll in the weeks indicated below.

*Each week may be 2 day, 3 day, or 5 day weeks.
Please indicate the weeks or partial weeks you want: ___________________________________________________________________________________________
If these weeks are not available, please return my deposit ___
If these weeks are not available, please put me on a waiting list ___
If these weeks are not available, please contact me about other possibilities ___

Cost of full week (Monday - Friday): $300 X _____ (#of weeks) = $__________

Cost of 3 day week (Mon, Wed, Fri) : $195 X _____ (#of weeks) = $__________

Cost of 2 day week (Tues and Thurs): $135 X _____ (#of weeks) = $__________

Deposit paid: $50 per week or partial week = $__________

Balance Due: = $__________         (______)   check here if you have paid on-line

Release and waiver of liability:
In consideration of the services to be received, the under signed hereby releases the International Tae Kwon Do Academy, its instructors and students, from any liability, by reason of injury, or suffering which may be sustained in the course of receiving instruction or services.
I have read and agree to the Release and waiver of liability, in consideration of the services to be received as a student of the International Tae Kwon Do Academy.


_____________________________________________   _______/_______/_______
Parent's Signature and date

| Pay online | Camp information: www.TKD.net/camp | International Tae Kwon Do Academy | webmaster@tkd.net |