IF WE CANNOT REACH YOU AT THE ABOVE NUMBERS PLEASE LIST AN ALTERNATE EMERGENCY CONTACT(S).

Please list any medications the participatingchild needs to have while at an Integrity Martial Arts, LLC Summer Program. Also, please indicate whether medications need to be taken during the I.M.A. Summer Program or if any medications are to betaken for an allergic emergency, etc. Parents assume responsibility for supplying any medications for their child. A child cannot be dropped off at an IntegrityMartial Arts, LLC Summer Program without medications he or she will (or may) need during the camp session hours (unless parents are going to dispense the medication to their child themselves). All medications should be labeled with the child’s name and have clearly printed instructions for dispensing signed by both the physician and guardian. Integrity Martial Arts, LLC assumes no liability for the dispensing of medications to participating children.

SUMMER PROGRAM DATES

Summer Program runsthese weeks:

• Week 1: July 10th - 14th Sword Summer Program including Star Wars Theme Day
• Week 2: July 31st -  August 4th Martial Arts Summer Program including Minecraft Theme Day
• Cost is $150 per week for Summer Program 9 AM - 12 PM. Also available as $60 per day.

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Summer Summer Program isan awesome training experience with tons of games, karate and fun. IntegrityMartial Arts� Summer Summer Program not only offers high-energy karate classes,but also plenty of games, movies and more! It�s a great opportunity for yourchild to receive extensive martial arts training! It is open to children ages6-16.

Sword Summer Program willinclude daily lessons on how to use, fight with and demonstrate fun swordtechniques. We will cover both traditional and modern sword martial arts.Weekly price includes wooden practice sword.

 Food: Pleaseprovide a snack and water bottle for your child each day.

PLEASE CHOOSE WHEN YOU WOULD LIKE TO ATTEND BY CLICKING BELOW!

By signing below, I understand and agree to abide by all ofthepolicies, requirements and financial obligations listed in this IntegrityMartial Arts, LLC (I.M.A.)  I assume all risks inherent and incidentalforparticipating with Integrity Martial Arts, LLC’s Summer Summer Program. Ihereby state that I am a legal guardian for the above referenced minor childand I acknowledge on the child’s behalf that the information on thisregistration form is correct. I also grant permission to use my child’s imageand/or name in promotional materials for Integrity Martial Arts,LLC. IntegrityMartial Arts, LLC reserves the right to dismiss (at any time) any childparticipating with the I.M.A.Summer Summer Program due to behavior thatI.M.A.’s staff or chaperones deem to bedisrespectful or dangerous. Parentswhose children are dismissed early due to behavior will be called to pick uptheir child from the I.M.A. Summer Summer Program.

I hereby acknowledgethat I recognize the risks inherent to the activities of martial arts and thiskind of sport activity.Furthermore, I acknowledge that Integrity Martial Arts,LLC, their instructors, their staff and agents are not responsible for anyinjury occurring during the course of my child’s participation at (or travelingto and from) any I.M.A. Summer Summer Program related activity.In addition, Igive permission for my child to walk from Integrity Martial Arts’ studio to alocal park and to partake in outdoor activities and field trips during theirI.M.A. Summer Summer Program.If an injury or an illness should occur to mychild during theirI.M.A. Summer Summer Program and if Integrity Martial Arts,LLC is unable to reach me via telephone, I give my permission to the staff orchaperones of Integrity Martial  Arts, LLC to authorize emergency medicaltransport and treatment for my child to/at a hospital.