children's winter holiday camp registration form - Queen of Apostles
o
Dates: June 23rd through August 29th
o
Drop off between 7:30am – 9:30am
o
Pick up between
o
Registration Fee $60 (Includes TKD uniform & Camp T-shirt)
4:30pm – 6:30pm
If you have UMS TKD Uniform you pay only $10 (Also get TKD Camp T-shirt) o
Who can attend: 5 yrs to 12 yrs old students
(13 yrs & up need special permission from Master) o
Taekwondo class, Discipline, Self confidence, Respect, Focus
o
Recharge your child’s energy and motivation!
o
10% discount for additional family members
Camp Includes: Taekwondo, Discipline, Exercise, Breaking Board, Arts & Crafts, Meadow Botanical Park, Mason District Park, Movies (at studio), Sports, Moon bounce, Swimming, Air and Space Museum, Korean Language etc ….. Field Trip Fee will apply for: Chuck E. Cheese, Reston Zoo, Movie Theater, US Bowling.
Visit our website and learn more about UMS: umsmartialarts.com
2014 Summer Camp Schedule MONDAYS
3:00 PM Games – Dodge ball, running, jumping recreations …
7:30 AM Kiss & Ride between 7:30 – 9:30 am. Play quiet activities, games, or a movie.
4:00 PM Line up & Learning Clean up responsibility.
9:30 AM The camp begins! Learn schedule and rules. Review manners at dojang, home & school.
4:20 PM Camp ends – Games, quiet activity, or movie until parents pick up before 6:20 PM.
10:30 AM Stretch out; team training Taekwondo
THURSDAYS
11:30 PM Lunch & rest; supervised free time. 1:00 PM Korean Language – greeting, words, Taekwondo terminology
7:30 AM Drop off campers between 7:30 – 9:30 am. Campers play quiet games & activities. 9:30 AM The camp begins! Korean language exercise.
3:00 PM Game time! Dodge Ball, Tiger & Mouse,P.E. Drills 4:00 PM Line up & Learning Clean up discipline. 4:20 PM Camp ends – Games, quiet activities, or movie until parents pick up before 6:20 PM.
TUESDAYS
10:30 AM Tae Kwon Do- Respect & Discipline Training 11:30 AM Lunch & swim safety briefing. Change & go swimming. 3:30 PM Return from the pool & change. a) Dodge Ball b) Tiger & Mouse c) P.E. Drills 4:00 PM Line up & Learning Clean up responsibility.
7:30 AM Kiss & Ride between 7:30 – 9:30 am. Play quiet activities, games, or a movie.
4:20 PM Camp ends – Games, quiet activities, or movie until parents pick up before 6:20 PM.
9:30 AM The camp begins! Arts & crafts project. 10:30 AM Taekwondo Class: One-step sparring & free sparring 11:30 AM Lunch & swim safety briefing. Change & go swimming.
FRIDAYS 7:30 AM Drop off campers between 7:30 – 9:30 am. Campers play quiet games & activities. 9:30 AM The camp begins! Write letters to parents.
3:30 PM Return from the pool & change. 2do Taekwondo -Discipline, Respect…
10:30 AM Taekwondo: Practice breaking techniques
4:00 PM Line up & Learning Clean up responsibility 4:20 PM Camp ends – Games, quiet activity, or movie until parents pick up before 6:20 PM.
11:30 AM Lunch & Supervise Free time, Moon bounce 1:00 PM Go to the Park (Sports – Soccer, bally ball, kick ball, play ground, Hiking, Running … etc ) 3:00 PM 2doTaekwondo - Board Breaking!
WEDNESDAYS
4:00 PM Line up & Learning Clean up responsibility.
7:30 AM Drop off campers between 7:30 – 9:30 am. Campers play quiet games & activities. 9:15 AM Taekwondo Class , Breaking skill, Targekicking, Climb rope, etc.
4:20PM
Camp ends – Games, quiet activities, or movie until parents pick up before 6:20 PM.
kicking skills, Target
11:00 PM Camp begins! Line up, divide into groups for this week’s BIG Field Trip: 1. Hidden Oak Center 6. U S Bowling 2. Chuck E Cheese 7. Movie Theater 3. Reston Zoo 8. Chuck E Cheese 4. Nat. Arboretum 9. Meadowlark Bot. Garden 5. Chuck E Cheese 10. Reston Zoo Lunch (included for weeks 1, 3, 4,7,9,10) & rest; supervised free time.
IMPORTANT NOTE Schedule is subject to modification. Students must bring a lunch & Snack After 6:30pm, there is a charge for late pick up (See Registration Form). SWIMMING GEAR required on Tuesdays & Thursdays CAMP T-SHIRTS must be worn on Wednesdays & Fridays TAEKWONDO UNIFORM is required on Mondays & Tuesdays
UMS 2014 TAEKWONDO SUMMER CAMP REGISTRATION FORM 6349 Columbia Pike, Ste. C Falls Church, VA 22041 703-914-1110 [email protected]
1. Camper Name: LAST
FIRST
LAST
FIRST
LAST
FIRST
LAST
FIRST
2. Camper Name: 3. Camper Name: Guardian Name:
Age:
M / F
Age:
M / F
Age:
M / F
Email:
Address: STREET
APT#
Home Phone:
CITY
STATE
W:
ZIP
C:
Emergency Phone: PHONE
NAME
RELATION
Any special conditions / allergies / medications we need to be aware of? 1
2 June 30July 3
June 23-27
No camp July 4th (Fri)
HIDDEN OAK NAT.CENTER
*CHUCK E CHEESE (lunch Include)
Date Register Until 4/5/14 Register Until 5/7/14 Register After 5/8/14
Indicate weeks attending: 5 6
3
4
July 7 - 11
July 14 - 18
July 21 - 25
*RESTON ZOO
NAT. ARBORETUM
*CHUCK E CHEESE (lunch Include)
rst
8
9
10
July 28 – Aug 1
Aug 4-8
Aug. 11 – 15
Aug. 18 - 22
Aug. 25 - 29
*US BOWLING (lunch Include)
*MOVIE THEATER
*CHUCK E CHEESE (lunch Include)
MEADOWLARK BOT.GARDEN
*RESTON ZOO
SUMMER CAMP RATES 4-7 Weeks $259 / week* $264 / week* $269 / week*
1-3 Weeks $269 / week* $274 / week* $279 / week*
$60 Registration Fee 1
7
8-11Weeks $249 / week* $254 / week* $259 / week*
time Per Camper (Includes UMS TKD uniform & Camp T-Shirt) - All others $ 10.00 10% discount for additional family members! * Field Trip Fees not included in weekly rates. (Chuck E Cheese $20 Includes Lunch & Tokens) (Bowling $20 Includes Lunch) (Movie Theater $20 – Includes Popcorn & Sprite Caffeine Free) (Reston Zoo $10 include animal feed-Bring own lunch for picnic)
Payment is due on the Friday 9 days in advance prior to the following week. If the payment is not completed by Friday, we will automatically charge a week prior from credit card a week prior without late fee.
Guardian’s Signature*:
_____Printed:
*By signing you have read and agree to the terms above.
_____ Date:
________
Office only REGISTRATION: $
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Pd On:
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CALCULATIONS & PAYMENT: Add Field Trip Fee ($20 each) to applicable weeks: Camper 1. X + =$ WEEKLY RATE
Camper 2. 10% OFF
# OF WEEKS
X WEEKLY RATE
Camper 3. 10% OFF
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=$
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Pd On:
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FIELD TRIP FEES
+ # OF WEEKS
$
FIELD TRIP FEES
+ # OF WEEKS
X WEEKLY RATE
UMS INITIALS
UMS INITIALS
=$
FIELD TRIP FEES
TOTAL $
*required
Auto Credit Card#: Exp. Date:
/ MONTH / YEAR
TERMS OF AGREEMENT: Payment/Cancellation/Modification Policy: Registration payment reserves the camper(s) listed above space in the camp. All payments are non-refundable. Payment for the week secures the entire week, even if the camper(s) listed above do not attend the entire week. If payments are not received on time the camper(s) will not be allowed in the camp. Payments made on Monday for that week are charged a late penalty of $25. If campers cannot attend due to physical reasons (ie. broken leg), a Doctor’s excuse must be provided in order for payments to be applied toward future camps or memberships. A $25 service fee made payable to UMS Martial Arts is charged for bounced checks. A $30 service fee is charged for modification/cancellation of weeks (not for adding weeks in advance). If cancellation occurs before May 17, 2013 and the camp was for paid in advance, 50% of the amount may be refunded. Late pick up charges are as follows and are to be paid before the camp ends each Friday: $10 from 6:316:45pm and $5 for every 15 minute segment thereafter. Failure to make payments will result in referral to a collection agency. Waiver and Release: I, as the child(ren)’s legal guardian, fully recognize that martial arts involves strenuous physical exercise and I am fully aware of the risks of injury and/or illness inherent in participation in any fitness or martial arts program, and I have taken all reasonable steps to determine, and hereby warrant, that my child(ren) is(are) in good health and physically capable of participating in the programs and courses of instruction offered by UMS Martial Arts. I understand and agree that all participation in any such fitness program or use of UMS Martial Art’s equipment or facilities on or off the premises, including field trips, shall be at our own risk. I authorize the officers and personnel of UMS Martial Arts to transport my child(ren) to and from UMS Martial Arts in any event, and in the case of a medical emergency I authorize UMS Martial Arts and its officers and personnel to seek medical attention for the camper(s) mentioned above. I also authorize the attending physician to perform any emergency treatment that is deemed necessary. I hereby release, indemnify, and hold harmless UMS Martial Arts and its personnel from and against any and all claims, suits, demands, damages, costs and liabilities of any kind or any kind of nature, including attorney’s fees and costs, for any injury, harm or fatalities of myself or my child(ren), or of any person(s) who become entitled to the use of the facilities of UMS Martial Arts by virtue of this agreement, or any third persons, which arise directly or indirectly out of or in virtue of our presence at UMS Martial Arts for any form of compensation or claim for any fatalities, harm or injuries sustained by our presence at UMS Martial Arts. Loss/Damage/Theft of Property: I understand and agree that UMS Martial Arts and its personnel shall not be held responsible for any personal property which is damaged, lost or stolen in or around UMS Martial Arts or its facilities, or at any of UMS Martial Arts’ off-premises events and field trips. Photographic Equipment: I hereby authorize UMS Martial Arts personnel to photograph me or my child(ren) and to utilize such photographs for commercial purposes, including but not limited to the promotion and marketing of UMS Martial Arts, and I agree that I nor any party acting on my or my child(ren)’s behalf shall not be entitled to receive compensation as a result of such use.
Guardian’s Signature*:
Printed: *By signing you have read and agree to the terms above.
_______________________ ______
___________ Date:
_____________
Dates: June 23rd through August 29th
o
Drop off between 7:30am – 9:30am
o
Pick up between
o
Registration Fee $60 (Includes TKD uniform & Camp T-shirt)
4:30pm – 6:30pm
If you have UMS TKD Uniform you pay only $10 (Also get TKD Camp T-shirt) o
Who can attend: 5 yrs to 12 yrs old students
(13 yrs & up need special permission from Master) o
Taekwondo class, Discipline, Self confidence, Respect, Focus
o
Recharge your child’s energy and motivation!
o
10% discount for additional family members
Camp Includes: Taekwondo, Discipline, Exercise, Breaking Board, Arts & Crafts, Meadow Botanical Park, Mason District Park, Movies (at studio), Sports, Moon bounce, Swimming, Air and Space Museum, Korean Language etc ….. Field Trip Fee will apply for: Chuck E. Cheese, Reston Zoo, Movie Theater, US Bowling.
Visit our website and learn more about UMS: umsmartialarts.com
2014 Summer Camp Schedule MONDAYS
3:00 PM Games – Dodge ball, running, jumping recreations …
7:30 AM Kiss & Ride between 7:30 – 9:30 am. Play quiet activities, games, or a movie.
4:00 PM Line up & Learning Clean up responsibility.
9:30 AM The camp begins! Learn schedule and rules. Review manners at dojang, home & school.
4:20 PM Camp ends – Games, quiet activity, or movie until parents pick up before 6:20 PM.
10:30 AM Stretch out; team training Taekwondo
THURSDAYS
11:30 PM Lunch & rest; supervised free time. 1:00 PM Korean Language – greeting, words, Taekwondo terminology
7:30 AM Drop off campers between 7:30 – 9:30 am. Campers play quiet games & activities. 9:30 AM The camp begins! Korean language exercise.
3:00 PM Game time! Dodge Ball, Tiger & Mouse,P.E. Drills 4:00 PM Line up & Learning Clean up discipline. 4:20 PM Camp ends – Games, quiet activities, or movie until parents pick up before 6:20 PM.
TUESDAYS
10:30 AM Tae Kwon Do- Respect & Discipline Training 11:30 AM Lunch & swim safety briefing. Change & go swimming. 3:30 PM Return from the pool & change. a) Dodge Ball b) Tiger & Mouse c) P.E. Drills 4:00 PM Line up & Learning Clean up responsibility.
7:30 AM Kiss & Ride between 7:30 – 9:30 am. Play quiet activities, games, or a movie.
4:20 PM Camp ends – Games, quiet activities, or movie until parents pick up before 6:20 PM.
9:30 AM The camp begins! Arts & crafts project. 10:30 AM Taekwondo Class: One-step sparring & free sparring 11:30 AM Lunch & swim safety briefing. Change & go swimming.
FRIDAYS 7:30 AM Drop off campers between 7:30 – 9:30 am. Campers play quiet games & activities. 9:30 AM The camp begins! Write letters to parents.
3:30 PM Return from the pool & change. 2do Taekwondo -Discipline, Respect…
10:30 AM Taekwondo: Practice breaking techniques
4:00 PM Line up & Learning Clean up responsibility 4:20 PM Camp ends – Games, quiet activity, or movie until parents pick up before 6:20 PM.
11:30 AM Lunch & Supervise Free time, Moon bounce 1:00 PM Go to the Park (Sports – Soccer, bally ball, kick ball, play ground, Hiking, Running … etc ) 3:00 PM 2doTaekwondo - Board Breaking!
WEDNESDAYS
4:00 PM Line up & Learning Clean up responsibility.
7:30 AM Drop off campers between 7:30 – 9:30 am. Campers play quiet games & activities. 9:15 AM Taekwondo Class , Breaking skill, Targekicking, Climb rope, etc.
4:20PM
Camp ends – Games, quiet activities, or movie until parents pick up before 6:20 PM.
kicking skills, Target
11:00 PM Camp begins! Line up, divide into groups for this week’s BIG Field Trip: 1. Hidden Oak Center 6. U S Bowling 2. Chuck E Cheese 7. Movie Theater 3. Reston Zoo 8. Chuck E Cheese 4. Nat. Arboretum 9. Meadowlark Bot. Garden 5. Chuck E Cheese 10. Reston Zoo Lunch (included for weeks 1, 3, 4,7,9,10) & rest; supervised free time.
IMPORTANT NOTE Schedule is subject to modification. Students must bring a lunch & Snack After 6:30pm, there is a charge for late pick up (See Registration Form). SWIMMING GEAR required on Tuesdays & Thursdays CAMP T-SHIRTS must be worn on Wednesdays & Fridays TAEKWONDO UNIFORM is required on Mondays & Tuesdays
UMS 2014 TAEKWONDO SUMMER CAMP REGISTRATION FORM 6349 Columbia Pike, Ste. C Falls Church, VA 22041 703-914-1110 [email protected]
1. Camper Name: LAST
FIRST
LAST
FIRST
LAST
FIRST
LAST
FIRST
2. Camper Name: 3. Camper Name: Guardian Name:
Age:
M / F
Age:
M / F
Age:
M / F
Email:
Address: STREET
APT#
Home Phone:
CITY
STATE
W:
ZIP
C:
Emergency Phone: PHONE
NAME
RELATION
Any special conditions / allergies / medications we need to be aware of? 1
2 June 30July 3
June 23-27
No camp July 4th (Fri)
HIDDEN OAK NAT.CENTER
*CHUCK E CHEESE (lunch Include)
Date Register Until 4/5/14 Register Until 5/7/14 Register After 5/8/14
Indicate weeks attending: 5 6
3
4
July 7 - 11
July 14 - 18
July 21 - 25
*RESTON ZOO
NAT. ARBORETUM
*CHUCK E CHEESE (lunch Include)
rst
8
9
10
July 28 – Aug 1
Aug 4-8
Aug. 11 – 15
Aug. 18 - 22
Aug. 25 - 29
*US BOWLING (lunch Include)
*MOVIE THEATER
*CHUCK E CHEESE (lunch Include)
MEADOWLARK BOT.GARDEN
*RESTON ZOO
SUMMER CAMP RATES 4-7 Weeks $259 / week* $264 / week* $269 / week*
1-3 Weeks $269 / week* $274 / week* $279 / week*
$60 Registration Fee 1
7
8-11Weeks $249 / week* $254 / week* $259 / week*
time Per Camper (Includes UMS TKD uniform & Camp T-Shirt) - All others $ 10.00 10% discount for additional family members! * Field Trip Fees not included in weekly rates. (Chuck E Cheese $20 Includes Lunch & Tokens) (Bowling $20 Includes Lunch) (Movie Theater $20 – Includes Popcorn & Sprite Caffeine Free) (Reston Zoo $10 include animal feed-Bring own lunch for picnic)
Payment is due on the Friday 9 days in advance prior to the following week. If the payment is not completed by Friday, we will automatically charge a week prior from credit card a week prior without late fee.
Guardian’s Signature*:
_____Printed:
*By signing you have read and agree to the terms above.
_____ Date:
________
Office only REGISTRATION: $
#
-
CC
Pd On:
/
/
|
CALCULATIONS & PAYMENT: Add Field Trip Fee ($20 each) to applicable weeks: Camper 1. X + =$ WEEKLY RATE
Camper 2. 10% OFF
# OF WEEKS
X WEEKLY RATE
Camper 3. 10% OFF
#
-
CC
Pd On:
/
/
|
.
$
#
-
CC
Pd On:
/
/
|
.
$
#
-
CC
Pd On:
/
/
|
.
$
#
-
CC
Pd On:
/
/
|
.
=$
$
#
-
CC
Pd On:
/
/
|
.
FIELD TRIP FEES
+ # OF WEEKS
$
FIELD TRIP FEES
+ # OF WEEKS
X WEEKLY RATE
UMS INITIALS
UMS INITIALS
=$
FIELD TRIP FEES
TOTAL $
*required
Auto Credit Card#: Exp. Date:
/ MONTH / YEAR
TERMS OF AGREEMENT: Payment/Cancellation/Modification Policy: Registration payment reserves the camper(s) listed above space in the camp. All payments are non-refundable. Payment for the week secures the entire week, even if the camper(s) listed above do not attend the entire week. If payments are not received on time the camper(s) will not be allowed in the camp. Payments made on Monday for that week are charged a late penalty of $25. If campers cannot attend due to physical reasons (ie. broken leg), a Doctor’s excuse must be provided in order for payments to be applied toward future camps or memberships. A $25 service fee made payable to UMS Martial Arts is charged for bounced checks. A $30 service fee is charged for modification/cancellation of weeks (not for adding weeks in advance). If cancellation occurs before May 17, 2013 and the camp was for paid in advance, 50% of the amount may be refunded. Late pick up charges are as follows and are to be paid before the camp ends each Friday: $10 from 6:316:45pm and $5 for every 15 minute segment thereafter. Failure to make payments will result in referral to a collection agency. Waiver and Release: I, as the child(ren)’s legal guardian, fully recognize that martial arts involves strenuous physical exercise and I am fully aware of the risks of injury and/or illness inherent in participation in any fitness or martial arts program, and I have taken all reasonable steps to determine, and hereby warrant, that my child(ren) is(are) in good health and physically capable of participating in the programs and courses of instruction offered by UMS Martial Arts. I understand and agree that all participation in any such fitness program or use of UMS Martial Art’s equipment or facilities on or off the premises, including field trips, shall be at our own risk. I authorize the officers and personnel of UMS Martial Arts to transport my child(ren) to and from UMS Martial Arts in any event, and in the case of a medical emergency I authorize UMS Martial Arts and its officers and personnel to seek medical attention for the camper(s) mentioned above. I also authorize the attending physician to perform any emergency treatment that is deemed necessary. I hereby release, indemnify, and hold harmless UMS Martial Arts and its personnel from and against any and all claims, suits, demands, damages, costs and liabilities of any kind or any kind of nature, including attorney’s fees and costs, for any injury, harm or fatalities of myself or my child(ren), or of any person(s) who become entitled to the use of the facilities of UMS Martial Arts by virtue of this agreement, or any third persons, which arise directly or indirectly out of or in virtue of our presence at UMS Martial Arts for any form of compensation or claim for any fatalities, harm or injuries sustained by our presence at UMS Martial Arts. Loss/Damage/Theft of Property: I understand and agree that UMS Martial Arts and its personnel shall not be held responsible for any personal property which is damaged, lost or stolen in or around UMS Martial Arts or its facilities, or at any of UMS Martial Arts’ off-premises events and field trips. Photographic Equipment: I hereby authorize UMS Martial Arts personnel to photograph me or my child(ren) and to utilize such photographs for commercial purposes, including but not limited to the promotion and marketing of UMS Martial Arts, and I agree that I nor any party acting on my or my child(ren)’s behalf shall not be entitled to receive compensation as a result of such use.
Guardian’s Signature*:
Printed: *By signing you have read and agree to the terms above.
_______________________ ______
___________ Date:
_____________
