Karate at Ormsby (St. Matthias)
Fall 2021 Program Registration

Fall 2021 Term September 14 December 16
 

Programs Offered 

Little Dragons (ages 5-7)
Classes: Tuesdays 6:00 pm 6:40 pm 

Children (ages 8-11)
Classes: Tuesdays and/or Thursdays, 7:00 pm 8:00 pm 

Youth & Adults (ages 12 and up)
Classes: Tuesdays and/or Thursdays, 8:15 pm 9:30 pm


St. Matthias Anglican Church Hall
6210 188 Street NW,
Edmonton,
AB. T5T 5T4
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Registrant Fee: $0.00


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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*OHTSUKAAMATEURKARATE 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.

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Registration inquiries:
Sensei Samantha Chan
akfOrmsby@gmail.com
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Privacy Policy
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Student Information
 

Emergency Contact Information
 

Waiver and Privacy Statements
WAIVER STATEMENT
I hereby acknowledge that I am aware and understand that the art and sport of karate is potentially hazardous and that a participant is exposed to risks in said activity. I further acknowledge that in the course of doing karate I, or the child I am registering, may receive injuries that may be serious and permanent.

I hereby acknowledge and accept all hazards and risks in the doing of said activity and hereby remise, release and forever discharge the Ohtsuka Amateur Karate Foundation, its officers, servants, employees, successors, agents and assigns from any and all claims and demands whatsoever for damages, loss or injury, however arising which may now or may hereafter by sustained by me, or the child I am registering, in consequence of my participation in the AKF Karate events and classes including, without limiting the generality of the foregoing, training, practice, competition, demonstration, travelling to or from any of the foregoing, and any other matter related in any way to the said activities.

PRIVACY STATEMENT
The Ohtsuka Amateur Karate Foundation is collecting this information in accordance with the Personal Information Privacy Act. This information will be used to maintain membership lists under the requirements of the Societies Act (1980), to contact members about the club or training times and in the event of an emergency with a member while training. This information will not be shared with any third parties except in case of medical emergency without prior written consent.
Check this box to indicate that you have read and agree to all of the above terms & conditions

COVID-19 Impacts
Before class start in September. the head instructor will share with you how the karate classes are changing to ensure all the students and instructors are kept as safe as possible.
Check the COVID19 page on our website for details on the accommodations there being made (http://akfkarate.com/covid-19-resources/).