Tae Kwon Do Registration

Contact Information

Country*
Email*
Confirm Email*
Phone (where you can receive text messages.)*
Child 1 name and grade*
Child 2 name and grade
Child 3 name and grade
Child 4 name and grade
Health and Emergency information: List any health conditions such as heart disease, diabetes, epilepsy, serve allergies, etc. If your child uses medications, please indicate.

Summer program Registration

What days will your child be attending?
  • Monday
  • Tuesday
  • Wednesday
Will your child need transportation? (check all that apply)
  • Yes, Monday
  • Yes, Tuesday
  • Yes, Wednesday
  • No

Please select quantity of "1" for the following membership choices.

Quantity
Price
Total
TKD Member Price - one child
X
$
45.00=
$
0

TKD Member Price - Two Children
X
$
50.00=
$
0

TKD Member Price - Family (2 or more children)
X
$
60.00=
$
0

TKD Non Member Price - one child
X
$
55.00=
$
0

TKD Non-Member Price - two children
X
$
60.00=
$
0

TKD Non-Member Price Family (more than 2 children)
X
$
70.00=
$
0

Final Total:
$
0
***While we are happy to provide a refund if your child is unable to attend, TRVCC has to charge a service fee for the refund which is approx 3.6%. By checking this box, you are authorizing TRVCC charge this fee if you do need a refund. ****
  • Yes, I agree.

Tae Kwon Do

Insurance Waiver:

            Participants are expected to provide their own health insurance or agree to be responsible for any medical expenses incurred.

            The undersigned acknowledges that any participant is covered by appropriate health insurance, or that you accept financial responsibility and acknowledge that The Tongue River Valley Community Center is not responsible for any medical expenses incurred as a result of injury.

 

Acknowledgement, Release And Waiver: I acknowledge that there are risks, including the possibility of serious bodily injury, connected with the use of the facilities, equipment and activities at the Tongue River Valley Community Center, Tongue River AJF, and TRLC including participation in any and all Group Fitness classes or athletic activities.  I understand that the risk of injury cannot be completely eliminated even by taking the utmost care.  For my minor dependants, and myself I voluntarily assume all risks of serious bodily injury or property damage associated with my use of the Community Center, including those resulting from negligence or fault.  I unconditionally release, hold harmless and indemnify Tongue River Valley Community Center, Tongue River AJF, and TRLC, its directors, employees, and representatives, the owner of the building premises, and all other persons from all claims of any kind, in law or in equity, including but not limited to death, bodily injury or property damage, related to or resulting from any activity engaged in by me at the Community Center, whether foreseeable or not, including those resulting from negligence or fault, theft, activities of other persons, or otherwise. I further agree to be responsible for replacement or repair of any damage caused by me to the building premises, or to property or equipment of Tongue River Valley Community Center, Tongue River AJF, TRLC or others.  I have not been pressured in any way to participate in activities at the Community Center, and any activities I undertake are done so voluntarily.  I have informed myself of the contents of the Acknowledgement, Release & Waiver by carefully reading it, and I sign this release voluntarily.

 

Consent for Emergency Medical Assistance

            I hereby authorize Tongue River Valley Community Center, Tongue River AJF, and TRLC Center staff members in charge of my child named below to obtain all necessary medical care for my child in the event that I cannot be reached to authorize it myself.  I hereby authorize any licensed physician and/or medical personnel to render necessary medical treatment to my child.

Waiver
  • Yes, I have read and understand the waiver

Payment Information

Amount*
$
Payment Type
We only accept credit/debit card payments. After you complete this form, select Submit to enter your card details into our secure transaction processor. Your submission will be processed when you finalize your secure payment information.
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