Summer Camp 2023 Application and Payments

PLEASE CHECK WEEK/ WEEKS ATTENDING (1 application per student please)

Student's Name*

Student's Age

Student's Date of Birth

Student's Shirt Size

Parent's/Legal Guardian Name*

Address

City

State

Zip Code

Cell Phone/ Best Reach Number During Camp

Waiver*

In consideration for my attendance and participation in this academy’s martial arts training, I, the student/ parent/ legal guardian, acknowledge the existence of certain inherent risks in this type of training and hereby agree to assume all risks. I further relieve EVOLUTION Aquatics, MATI Clubs, MATI, Paulo Mushu, Checkmat, its management, assigned staff, and fellow students, from any liability resulting in personal injury or loss of personal belongings. I also hereby state that the students named above are physically fit to take the prescribed course of instruction and do so of their own free will for an agreed upon fee. I grant and authorize MATI Clubs the right to take, edit, alter, copy, exhibit, publish distribute and make use of any and all pictures, video and/or audio taken of applicant to be used in and/or for any lawful promotional materials, included, but not limited to newsletters, flyers, posters, brochures, advertisements, websites, social networking sites and other print or digital communications without payment or any other consideration. I waive the right to inspect or approve the finished product wherein the applicant’s likeness appears, including written or electronic copy and waive any right to royalties or other compensation arising or related to the use of these images or recordings. I understand there is a NO REFUND POLICY on any monies I will pay to this academy or representative of said academy. A parent or legal guardian signature is required if the student is under the age of 18..
I grant and authorize MATI Clubs the right to take, edit, alter, copy, exhibit, publish distribute and make use of any and all pictures, video and/or audio taken of applicant to be used in and/or for any lawful promotional materials, included, but not limited to newsletters, flyers, posters, brochures, advertisements, websites, social networking sites and other print or digital communications without payment or any other consideration. I waive the right to inspect or approve the finished product wherein the applicant’s likeness appears, including written or electronic copy and waive any right to royalties or other compensation arising or related to the use of these images or recordings

PLEASE LIST ANY FOOD ALLERGIES/ MEDICAL CONCERNS:

I Understand*

Students may attend any/ all camps (see restrictions on weeks 3 and 6). Students WILL test in full week (1/2 or full day) camps up to three times during summer 2023 (must attend one camp per month to qualify for testing three times). If students attend more than three full week (1/2 or full day) camps, they will not test that/ those weeks THEREFORE deduct $50 from the cost of that camp week. SPACE WILL BE LIMITED TO 30 STUDENTS FOR ALL CAMPS. REGISTRATION IS ON WEBSITE. www.maticlubs.com or feel free to submit the printed, completed application in person. We accept cash, check (made out to MATI CLUBS), or card.

I Agree*

THERE IS A $50 NON-REFUNDABLE DEPOSIT FOR EACH STUDENT/ FOR EACH CAMP AT TIME OF REGISTRATION. BALANCE IS DUE BY MAY 1, 2023. HOWEVER, WE WOULD PREFER PAYMENT IN FULL AT TIME OF REGISTRATION.

Camps

(JULY 5-7) BJJ 3 day camp $90

Select this camp

Weeks 3 & 6*

This is a JR Black Belt and Black Uniform Students Only. By Checking this box you understand this requirement

How Much are You Paying?

Total

Credit Card

Cardholder Name

Card Details

Agree*

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