BEST Summer Camp 2018


Don’t sweat summer plans for your kids! The solution is simple with Black Belt America’s Karate Summer Day Camps! Give your kids a great summer by registering for Black Belt America’s action-packed Summer Camp for kids—Every day is something new! From karate classes and swimming to arts & crafts, movies, field trips, and more, we’ll give your kids a summer to remember!


MORE BENEFITS THAN ANY OTHER DAY CAMP! At Black Belt America's Summer Camp, our Black Belt instructors will teach your kids the basics of karate in a fun and safe setting. As they learn, they’ll be building valuable self-defense skills and bully management techniques. Along the way, our Black Belt Instructors will teach your kids important lessons of self-discipline self-respect, and respect for others, all while gaining a lifelong appreciation for physical fitness! Because we mix karate with so many other great activities that kids love, your kids will be having the time of their lives while reaping dozens of rewards!


6121 Odana Rd
Madison, WI 53719
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Registrant Fee: $0.00


Billing information


Billing and Payment
Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*BLACKBELTAMERICA 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

Applicant Signature
Please enter your full name in the space below.
 


Please click the button below to finalize your registration.



Registration inquiries:
608-273-4111
info@blackbeltamerica.com
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Please fill out the information below once per child. If you have two children attending camp, the form needs to be filled out for each of them.
 
If you have already filled out this form and simply want to change or add weeks to your child's schedule, please do so by sending an email describing the change to bbamadison@blackbeltamerica.com.
 
 
 
 
STUDENT INFORMATION:
 
 
PARENT / GUARDIAN INFORMATION:

 

 

TUITION INFORMATION:

Registration Fee…$25 (includes camp t-shirt)

Weekly Cost…$209

Additional Family Members - 10% off/wk

BBT Members - $20 off/wk


 

Week 1...6/11 - 6/15
Week 2...6/18 - 6/22
Week 3...6/25 - 6/29
Week 4...7/2, 7/3, 7/5, 7/6 (no 7/4)
Week 5...7/9 - 7/13
Week 6...7/16 - 7/20
Week 7...7/23 - 7/27
Week 8...7/30 - 8/3
Week 9...8/6 - 8/10
Week 10...8/13 - 8/17
Week 11...8/20 - 8/24
Week 12...8/27 - 8/30 *4 days this week
 
 
REQUIRED CLOTHING
 
Students are required to wear their camp t-shirt every day. One shirt is included in your registration fee, and additional shirts can be purchased for $15.
 
If your child arrives at camp without their camp shirt, one will be provided for them and your account will automatically be charged $15. If you choose additional shirts, your account on file will be charged.
 
Students are also required to have their karate uniform at camp each day to participate in martial arts class. If you are a new student, a uniform will be provided for you on the first day of attendance.
 
Each camper is provided with a bin to keep their karate uniform in throughout the week. We recommend taking the uniform home on weekends to be washed.
 
 
SNACK OPTIONS
 
BBA provides two opportunities each day for campers to have snack. You have two options:
 
1. Send snacks from home for your child.

2. Set up a BBA snack account for your child. In this case, we set up an account starting with a $20 charge to your account. When your account gets to $2, we will automatically process a $20 payment to replenish the account.
 
 
 
Please indicate if your child requires a booster seat in the van when transported during field trips. Boosters will be provided by BBA.
 
 
HEALTH HISTORY AND INFORMATION
If your child requires medication while at camp, a "Medication Authorization Form" is required to be on file at BBA. This form can be filled out when you drop off the medication.
 
 


No specific medical condition
Asthma
Cerebral palsy / motor disorder
Diabetes
Epilepsy / seizure disorder
Gastrointestinal or feeding concerns including special diet and supplements
Any disorder including Cognitively Disabled
Food Allergies - specify foods
Non-food allergies - specify
BBA will provide sunscreen and insect repellent for all campers unless otherwise indicated.
 
All campers are required to have a current immunization record on file with BBA. This information can be emailed to info@blackbeltamerica.com. Immunization records must get to BBA prior to May 1st, 2018, or your registration will be cancelled. If you provided these records last year, we are still required to have an updated copy for this year's registration.
 
 
 
 
 
WEEKLY TUITION POLICIES:
 

Weekly payments will be automatically deducted the Thursday prior to attendance, unless weeks have been pre-paid. The EFT or credit card information you provided at the time of registration will be used for all future tuition payments, snack deposits, and additional shirts (if applicable).

If payment is not made by the Thursday before a camp week, a late fee of $5 per day will be assessed and your child may be removed from the roster for the following week. There is a return fee of $20 for returned payments.

f you need to change your payment method at any time, please contact us at 608-273-4111 to do so.

Date Changes are subject to availability in the camp. To make any changes to your camp reservations, we require a 30 day written notice. If we do not receive a full 30 day notice, you will be responsible for an automatic $15 change fee.

NO CANCELLATIONS. Because of the limited camp space available, weeks cannot be canceled. You will be responsible for payment for all weeks you are registered.

 


Please CLICK HERE to view the Parent Handbook

PLEASE READ the Terms & Conditions carefully. It is important that you understand the policies and procedures that Black Belt America has implemented.
_____ I understand that choosing which weeks my child will attend constitutes an agreement on my part to pay for those weeks regardless of attendance.

_____ I understand that Black Belt America is licensed by the state of Wisconsin as a Summer Day Camp. Their intent is to teach Martial Arts physical and philosophical character building skills.

_____ I have received the Parent Handbook will supply my child items accordingly.

_____ I give my consent for emergency medical care or treatment to be used if I cannot be reached immediately.

_____ Waiver & Release: I understand that all possible precautions are taken to ensure that the karate programs and activities at Black Belt America are conducted by mature and qualified personnel in a safe and responsible manner. However, I fully understand that because of the nature of some activities within the karate program there is a potential for accidental injury. I do recognize these risks and agree to allow my child to participate in the karate program. I further authorize Black Belt America staff to make decisions regarding emergency medical care for my child.

_____ I give permission for my child to attend activities which are held off camp grounds including walking trips and vehicle transported trips. I am aware that Black Belt America cannot assume responsibility for any accident or illness going to, from, or during the trip and therefore release Black Belt America and its agents, servants, and employees from any liability for any injury or illness to my child. I agree to assume these risks and waive any claim against Black Belt America, employees or agents as to any injury that may occur to my child(ren).

_____ I have informed the Black Belt America staff of any allergies or other medical conditions my child has. Unless otherwise listed, I give permission for Black Belt America to apply sunscreen, insect repellant, and other non-medicinal products to my child for outdoor activities.

_____ I have carefully read the entire document (including the Parent Handbook) and fully understand and agree to comply with every detail including tuition and any condition for dismissal. I also grant permission to Black Belt America to use any individual or group photographs of my child(ren) taken in karate activities for publication and advertising purposes.

_____ Loss/Damage/Theft of Students Property: Black Belt America does not assume any responsibility for the loss, damage or theft of any property belonging to the student. The student agrees that Black Belt America and its personnel are not responsible for or liable for any such property even if its loss, damage or theft occurs on or about Black Belt America.

_____ I will send my child with their BBA camp t-shirt every day. I understand that if my child does not have their camp t-shirt, one will be provided for them and my account will be automatically charged $15.

_____ I understand that Black Belt America reserves the right to dismiss any camper without a refund, where conduct is detrimental to campers. BLACK BELT AMERICA DOES NOT MAKE UP SICK DAYS OR GIVE REFUNDS FOR MISSED TIME.

Check this box to indicate that you have read and agree to all of the above terms & conditions