Golden Fleece Karate

Mondays: 5:00 pm – 6:00 pm
January 27, 2020 – April 6, 2020
Level: Beginner and Intermediate

Wednesdays: 6:00 pm – 7:00 pm
January 22, 2020 – April 1, 2020
Level: Beginner and Intermediate

Sundays 3:00 pm – 4:00 pm
January 26, 2020 – April 5, 2020
Level: Beginner, Intermediate and Advanced

Fees:

Beginner: Members: $198.00, Non-Members: $253.00

Intermediate: Members: $220.00, Non-Members: $275.00

Advanced (Sunday Only): Members: $264.00, Non-Members: $297.00

Members please use code “karatemember2020” at checkout and for any Sunday Advance classes please use code “karateSunmember2020”

$253.00 – $297.00

Day of the Week:

Class Type:

Clear

Child's Name*
First Last
Gender*
- Male
- Female
Date of Birth*
Age:*
Home Address*
Street Address Apt City State Zip
Parent/Guardian 1:*
First Last
Phone Number:*
Parent/Guardian 2:
First Last
Phone Number:
Email*
Emergency Contact Name*
First Last
Emergency Contact Phone Number*
Emergency Contact Relationship to Child:*
Membership:*
- Yes
- No
If Yes, Experation Date:*
How Did you Hear About Us?*
SECURITY ENTRY CARDS (FOR NON-MEMBERS ENTRY ONLY): $5 EACH FIRST 2 CARDS; $10 EACH CARD THEREAFTER **NON-REFUNDABLE**
T&C*
I hereby give permission to the Kings Bay YM-YWHA, Inc. to take photographs of me and/or my child to be shown in a video, brochure, advertisement, or internet display for purposes of promoting interest in the Kings Bay YM-YWHA. I release the Kings Bay YM-YWHA, Inc. from any claims resulting from the pictures taken on, before, or after the date of this communication. I do hereby give permission for my child to participate in all activities, including off-ground activities. I authorize the Kings Bay YM-YWHA, Inc. to act as parent surrogate on my behalf. I realize that itineraries and/or programs are subject to change prior to, and during, the semester. I hereby give my permission for my child to participate in all programs, activities and trips as part of the 2020 Kings Bay YM-YWHA children’s programming offerings. I understand and fully recognize that risks are involved. I hereby release the Kings Bay YM-YWHA or any of its sponsors, benefactors, or employees from any liability arising out of any injury to my child. In the event of a medical or surgical emergency, I grant permission to the physician designated by the Kings Bay YM-YWHA to hospitalize, secure proper treatment for, and order injections, anesthesia or surgery for my child. Furthermore, I understand that payment for medical services is solely the family’s responsibility.
I have carefully read the contract and other related information and agree to accept all terms as set forth above. Refund policy: No refunds will be issued for any classes missed or cancelled. The Kings Bay Y will attempt to offer make-up class.
Signature*
First
Today's Date*
MM slash DD slash YYYY

SKU: N/A Category: Specialty Classes

Description
Additional information