Spring Break and Summer Camps
9am - 3pm
Children must bring a bagged lunch everyday unless otherwise noted.
A mid-morning snack and drink will be provided.
Participants will receive a full schedule of activities one week prior to camp. Karate uniforms are NOT required, but can be purchased for $45

1655 East 14th St.
San Leandro, CA
94577 USA
Click for a larger map
INFO:   Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and/or are not selectable.

How would you like to pay?

When would you like to pay?

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*PALLENSMARTIALARTS 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:
Felipa Ortiz-Pallen
(510) 483-6560
= required field
Privacy Policy
Oops! You do not have javascript enabled. This registration process depends on javascript to function correctly.

Please enable javascript in your browser and then reload this page.
Registrant   remove this registrant

Spring Break Camp - April 2-6
Summer Session 1: June 11-15
Summer Session 2: June 18-22
Summer Session 3: July 9-13
Summer Session 4: July 30-Aug 3
Summer Session 5: Aug 6-10
HYPER Session 6: June 25-29 (Sophomore and above students only)
HYPER Session 7: July 23-27 (Sophomore and above students only)
PLEASE NOTE: The total camp fee includes all of the field trips, and their respective admittance fees. NO extra charges during the camp. An Itinerary will be provided upon payment in full. PLEASE pack a lunch as well as extra drinks and snacks!
The undersigned as parent or legal guardian of the minor child listed above, does hereby give permission for the above named individual(s) to attend the Pallenís Martial Arts Summer Camp, at 1655 East 14th Street. I further understand that the participants will be attending files trips during this time. As a condition of attending, I do hereby release Pallenís Martial Arts and all its affiliated schools and organizations, as well as their officers, agents, employees and students, from any and all claims, demands, actions, or causes of action due to death, injury, or illness, in any way, arising from the above described activity, including, but not limited to transportation to and from the trips. I further agree that the financial responsibility for securing care, in the case if injury resulting from participation in the program, is a matter between the participant and his/her health care provider, and that Pallenís Martial Arts cannot pay health care providers for treatment of any injuries. It is further agreed that the participant will assume all legal responsibility for their personal safety and actions while participating in the program and while traveling to and from the activities. I understand that my child(ren) must meet at Pallenís Martial Arts at 9:00 AM and must be picked up no later than 3:00 PM unless otherwise arranged with Pallenís. I can be reached at all times at the phone numbers listed below.

I hereby authorize the treatment, administration of anesthesia, surgical treatment(s) for my minor child(ren), listed above, in the event of a medical situation occurring in my absence or when the hospital or physicians are unable to contact me. This authorization extends to any hospital, physicians(s), and nursing personnel within the physicianís staff where treatment in rendered. I release from medical responsibility and liability Pallenís Martial Arts, the hospital, physician(s) and nursing personnel for performing medical procedures and acting on the authority of this medical treatment consent for which such medical providers deem necessary for my minor child(ren).
Check this box to indicate that you have read and agree to all of the above terms & conditions