subject_line
New Member Registration
Trial Class or Enrollment.... (choose one)
Choose one
*
Trial Class
Enrollment Class
Membership
Membership Type
*
🛈
Basic ($25)
Gold ($75)
Platinum ($150)
Membership Classes
*
Drop In ($40)
1 Day Wk ($140)
2 Days Wk ($160)
3+ Days Wk ($210)
Enter code
🛈
Choose Program
Programs:
*
Ninja
Youth
Teen
Adult
Family
Weapons
Taekwondo
Self-Defense
Select Day / Time
Choose Day:
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Choose Time:
*
9am
10am
11am
-
3pm
4pm
5pm
6pm
7pm
7:30pm
Choose 2nd Day :
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Choose Time:
9am
10am
11am
-
3pm
4pm
5pm
6pm
7pm
7:30pm
Student Information
Student First Name
*
Student Last Name
*
Address
*
City
*
State/Province
*
Alabama
Alaska
Alberta
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon
Zip/Postal Code
*
Email Address
*
Birthdate
*
+
Age
*
Martial Arts Experience
*
None
Beginner
Intermediate
Advance
Phone
*
Preferred way to contact
*
Phone
Email
Any
Parent/Guardian Information
Parent First Name
*
Parent Last Name
*
Date
*
Release of Liability
*
The participant or legal guardian has read Camp Carter International policies and procedures set forth in consideration of applicant’s participation in classes with Camp Carter International. Participants and/or legal guardian agree to defend, indemnify and hold harmless Camp Carter International, its officers, agents and employees from and against any and all claims, demands, causes of action or liabilities incurred by Camp Carter International arising, in whole or in part, directly or indirectly, from participant’s acts or omissions in connection with participation in the classes described. Further, participant and legal guardian agree to release Camp Carter International from any and all claims for damages, including property damage, injury or death occurring or arising out of use of, or participation in, Camp Carter International classes. I, the undersigned parent/guardian acknowledge that the participant is enrolled in a recreational program, NOT licensed child care. I also understand that Camp Carter International may photograph or videotape the events or activities in which I am (or my child) for the purpose of promoting Camp Carter International and its programs. I give my permission with the understanding that no compensation of any kind will be paid to me (or my child) now or in the future for the use of my (or my child’s) likeness. I agree to give 30 day notice before I cancel this program or will pay the value of the next month or twenty-five dollars per month from the start of the year. I HAVE READ THE AGREEMENT AND FULLY UNDERSTAND THAT I ASSUME ALL RISKS FOR INJURY RECEIVED.
I understand this membership commitment for a minimum of 6 months - after that time I agree to give 30 days’ notice by 1st of month before I cancel this program.
*
Please sign
*
clear
Powered by