Summer Camp 2018at Kang’s Black Belt Academy

Kang’s Black Belt Academy, 18200-C Georgia Ave., Olney, MD 20832Phone: 301-570-1106 kangs.lempert@gmail.com kangs.ninja

Get ready for a summer of fun at Kang’s Day Camp !June 18-22June 25-29July 23-27July 30-August 3August 20-24August 27-31

See Registration Form on back of flyer.

- Camp for ages 4 and

up

- Karate, Movies, Games, Art

- Water Play, Sports

- New Students Welcome

- No karate experien

ce

needed

Summer CampKang’s Black Belt Academy

Summer Day CampsRegistration 2018

Student Information (please use 1 form for each child)Student Name __________________________________________________ Date ____________ Age ________School Attending ____________________________________________________ Male ____ Female _____Parent’s/Guardian’s Names ___________________________________________________________________________Address __________________________________________________________________________________________Mom’s email______________________________ Mom’s Work Phone ____________ Mom’s Cell Phone ____________ Dad’s email _______________________________Dad’s Work Phone _____________ Dad’s Cell Phone _____________Emergency Contact _________________________Phone __________________ Relationship ______________________How did you hear about us? Website___ Friend___ Existing Student___ School Brochure___ Other___Check Week(s) Attending:____ Week 1: June 18-22 ____Week 3: July 23-27 ____Week 5: August 20-24____ Week 2: June 25-29 ____ Week 4: July 30-August 3 ____Week 6: August 27-August 31

Tuition Rate for Campers 1 Week 2 Weeks 3 Weeks 4 Weeks 5 Weeks 6 WeeksFirst Student (includes $30 discount for more than 1 session)

$300 $570 $840 $1,040 $1,275 $1,530

Sibling Tuition (includes sibling and multiple session discounts)

$275 $520 $740 $900 $1,125 $1,380

• Camps run Monday-Friday from 8am - 4pm. If after care is needed, please call the studio in advance.

• Students should bring a sack lunch and snack each day. We will provide an additional snack each day. Fridays are Pizza Days (no lunch needed)

• Fridays: If you would like to, bring a favorite game to play and share.• Students should bring swim wear, towel, sunscreen, and/or change of clothes for water play.• Everyone gets a camp T-Shirt on the 1st day of camp. Credit Card Payment

Type of card: Master Card ____ VISA ____ Discover ____Card Number: _____________________________________Expiration Date: ________________Security Code________

Releases Does student take prescription medication? Yes ____ No ____If yes, medication and purpose :____________________________________________________________________________Any allergies to medications? ___________________________

In case of accident or injury, I hereby certify that the above named student is to be given any emergency treatment neces-sary at any hospital reasonably accessible.

Parent/Guardian Signature______________________________________ Relationship___________ Date_____________

Photography ReleaseI hereby permit KBBA to use, in whole or in part, photographs and or videos of the above Named Student for the purpose of illustrations and publications, including our website. No student names will be published.

Parent/Guardian Signature______________________________________ Relationship___________ Date_____________

Mail or Deliver the registration form with payment to:Kang’s Black Belt Academy, 18200-C Georgia Ave., Olney, MD 20832,

Phone: 301-570-1106

Applications may be submitted by mail, or by hand when the office is open (4:30 - 8:30 pm)

Include full tuition with registration form(s); discounts only apply if paid at least 2 weeks before camp starts.