Gainesville and Flowery Branch Mixed Martial Arts Training Center

Call us: 678-450-0055


Summer Camps-2017

Kids Karate in Gainesville and Flowery Branch  - Rock Solid Karate

                    2017 Summer Camp Pre-Registration Form

Camp Hours are 9:00am – 3:00pm.  Early drop off starting at 7:30am and late pick-up until 5:00 are available at no extra charge. Ages 5-13.

To reserve your spot you must complete this form along with an auto debit form of payment which will be collected on the Monday prior to your camp week.  There is also a $25 nonrefundable deposit due at the time of registration to reserve your spot.  This will go toward the price of your camp but is nontransferable to other camps.

Please check the box below of the camp or camps you are attending.

Camp 1 June 5th-9th Return of Super HeroWeek

Camp 2 June 12th-16th Pokémon Week

Camp 3 June 19th-23rd Dojang Dodgeball

 

Camp 4 June 26th-30th Water War Week

 

Camp 5 July 10th -14th Rock Solid Builder

 

Camp 6 July 24th-28th Ultimate Nerf Week

 

I authorize Rock Solid karate to collect the balance due for each camp week on the Monday prior to each camp by:

Credit/Debit Card______

Payment information is as follows.

Name on Credit/Debit card:____________________________

Credit Card Number: __________________________________          Exp. Date:____________   CCV:__________

________ I authorize Rock Solid Karate to debit the credit card account above.

Signature: _________________________________________  Date:__________________________

FILL OUT WAIVER ON BACK

 

Pre-Registration Price: $135 for Pre-Registration (Deadline May 15th)

Late-Registration Price: $150 for late Registration (After May 15th)

 

Click here to follow us on facebook

After School Martial Arts &

                                                                                                                                Summer Camps

3042 McEver Road, Gainesville, GA 30542

678-450-0055      lee@rocksolidkarate.com

MEDICAL INFORMATION/WAIVER FORM

WaiverDate: _____/_____/_____

Child’s Name: ______________________________________ D.O.B._________________

Child’s Name: ______________________________________ D.O.B._________________

Parents/ Legal Guardian: ____________________________________________________

Primary Phone: __________________________

Secondary Phone: ________________________

Emergency Contact & Phone: _________________________________________________

Family Physician: ______________________________ Phone: _______________________

Medical Insurance For Child: ___________________________ Policy:__________________

Allergies & Medications: ________________________________________________________________

Consent

I (Parent or Guardian) give my consent to Rock Solid Karate, Inc. its officers, agents, employees, individuals associated with the organization or any emergency medical personnel to administer necessary treatment to my child named above in the event of an emergency and authorize transportation for my child by ambulance if situation warrants.

__________ (initials)

I (Parent or Guardian) give my consent to Rock Solid Karate, Inc. its officers, agents, employees, and individuals associated with the organization to transport my child named above to and from Rock Solid Karate’s authorized activities and events.

__________ (initials)

Karate World of Oakwood, Inc. and Rock Solid Karate, Inc. reserve the right to dismiss any students, at any time, for misconduct or actions which may convey a negative image of the martial arts in general and Karate World of Oakwood, Inc. and Rock Solid Karate, Inc. specifically.

I hereby acknowledge that Karate World of Oakwood, Inc. and Rock Solid Karate, Inc. are not responsible for any injuries suffered while on the premises of Karate World of Oakwood and Rock Solid Karate 3042 McEver Road, Gainesville, GA 30504 or any satellite facilities which we are instructing, or off premise field trip locations.

____________________________________                            ________________                                        ___________________

Signature Parent/Legal Guardian                                                              Date                                                                      Instructor

 

 

 



Request More Information

Cancel