2022 Summer Camp 2022 Summer Camp Summer Camp Registration Camp hours of operation: Monday – Friday 7:30 a.m. – 6:00 p.m. Student Information: Please complete one form per enrolled student, including siblings. This allows for us to account for medical or allergy needs of each child. Name * Name First First Last Last Preferred Name: Date of Birth (MM/DD/YYYY): * Gender: * Male Female Allergies: * Yes No Epi-pen required for allergies? * Yes No N/A If yes to allergies, list known allergies here: Known medical concerns (if none, type "none"): * Address: * City: * State: * Zip Code: * Parent / Guardian Information: Custodial parent(s) or legal guardian(s) information should be included here. Only one parent / guardian name is required. Name * Name First First Last Last Name Name First First Last Last Phone * Email: Address: * City: * State: * Zip Code: * Emergency Contacts: Persons who can be contacted in the event of an emergency. Emergencies may include medical emergency, late pick-up, or other circumstance where a parent / guardian needs to be reached but YHTKD is unable to make contact with said parent / guardian. Please note: Contact will always be attempted with the parent / guardian first. Name * Name First First Last Last Phone: * Relationship: * Authorized to Pick-Up: Persons who are not custodial parents or guardians but are authorized to pick-up. Parent / Guardian are still required to notify YHTKD in advance of pick-up if adjustments to the child's regular routine are being made. Name Name First First Last Last Name Name First First Last Last Name Name First First Last Last Summer Program Rates (All rates are based on a per child basis. Please Note: Your child's spot is not reserved until successful payment has been made along with registration.) April 2nd - May 1st 10 weeks for $1,250.00 -OR- A weekly rate of $150.00* *2-weeks must be paid in advance May 2nd - August 5th 10 weeks for $1,500.00 -OR- 4 weeks for $600.00 -OR- A weekly rate of $175.00* *2-weeks must be paid in advance Acknowledgements & Waivers Tuition Payments Weekly fees are to be paid in advance, prior to the week of attendance. Late payments will be assessed a $10 late fee. If fees are not paid within 1 week of due date student will not be permitted to attend until account is current. Student's parent/guardian is responsible for making alternative arrangements. Payments may be made in person, online, or via telephone (M- F 1 p.m. to 8 p.m. and Sat 10 a.m. to 2 p.m.) Late Pick-Up Fees Students are to be picked-up no later than 6:00 p.m. A 5 (five) minute grace period will be allotted to account for traffic delays and inconsistent clocks. Parents / Guardians will be billed $1.00 per minute for each minute they are late if they arrive for pick-up after the grace period. For example, if a parent / guardian arrives at 6:06 p.m. they will be billed $6 for the late pick-up. This can be paid at time of pick-up or included with weekly tuition. Release Yung Ho Tae Kwon Do Federation (YHTKD) is not a daycare but a facility with the intent on teaching martial arts physical and philosophical character. Weekly fees are based on the presumption the student will remain in the program for the entire school year and attend program no more than 22 hours per week. Payment is due whether the student is present or not. Attendance exceeding 22 hours per week constitutes participation in extended, enrichment or camp programs and incur an additional fee. YHTKD must be notified prior to 12:00 noon if your child is not attending school or does not require pick-up. YHTKD may be contacted by phone at (813) 935-8888. Failure to notify YHTKD will result in a $10 non-notification fee per occurrence. Withdrawal from the program requires one week's notice. In the event notification is not provided one week’s fee will be due. Students picked up after program end time will be subject to a $5 fee for the first 5 minutes and $1 per minute until student is picked up. Yung Ho Tae Kwon Do Federation is not responsible for loss, damage or theft of student’s property. Custody Arrangements In the event of a legally binding (or court ordered) custody arrangement, the custodial parent will be required to provide a copy of custody papers to YHTKD in order to validate and adhere to custody arrangements and schedules. Electronic Signature (Enter first and last name as it appears above) * Date (MM/DD/YYYY): * reCAPTCHA If you are human, leave this field blank. Submit