REGISTRATION

AFTER SCHOOL KARATE ACADEMY
Karate Registration
Dear Parents,

Summer Camp is here and we have some great activities planned to keep your child engaged and having fun throughout the Summer. You will find a copy of the academy policies, fees and registration details, and all forms needed for complete registration.

Forms to Complete

  • Copy of Immunization records (required)
  • Physician’s medication authorization (If applicable)
  • Asthma Action Plan (If applicable)
  • Signed copy of ASKA policies
  • Student Health History Form (required)
  • Completed Child Care Agreement forms (required)
  • ASKA code of Conduct

**Please note that before your child(ren)can be fully enrolled, the forms above must be completed, signed and returned tothe Front Desk, and registration fees must be paid in full.

Students attending ASKA Summer Camp are required to bring the following daily:
❏ Water bottles for park days and field trip days
❏ Lunch (no items will be warmed/cooked utilizing the microwave)
❏ Snack (for AM snack time, as PM snack will be provided by ASKA)
STUDENTS WHO COME TO CAMP WITHOUT A LUNCH or SNACK will be assessed $11 for Subway lunch and/or $2 for snack.We will also go to the splash park weekly, have craft days, virtually travel to spaces not yet open to the public and learn karate. SPACE IS LIMITED - so sign-up TODAY!

Child Care Agreement to Begin Care

Purpose: The purpose of this agreement is to state the basic rights and responsibilities of the parent/guardian and ASKA in the on-going care arrangements for the child(ren). This agreement is based on the premise that care of the child(ren) is supported by clear understanding and continued communication between the parent/guardian and
ASKA.

This agreement to provide child care in exchange for monetary compensation is between ASKA (identified below)and the parent/guardian(s) of:

Child(rens) Name(s)

Child Name
Child Name
First
Last
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Parent/Guardian Name(s)

Parent/Guardian Name
Parent/Guardian Name
First
Last
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Address
Address
City
State/Province
Zip/Postal
Country

Telephone Number(s)

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Email Address(es)

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Provider Name:
ASKA

Provider Address:
6950 Laurel Bowie Road
Bowie, MD 20715

Provider Contact Number:
301-805-8721 main
301-805-8700 2nd line
EMAIL: afterschool@karateacademybowie.com

Contact Name:
Hamid Shahraki

ASKA does not discriminate against anyone on the basis of race, sex, color, creed, national origin, disability, ancestry, or sexual orientation. ASKA reverses the right to refuse admission to the facility for enrollment based on the staff availability and needs of the prospective enrollee.

Standards of Care
ASKA agrees to uphold the standards of care based on the State of Maryland Licensing and Compliance Offices for Childcare. ASKA will be responsible to ensure up to date licensing is available upon request. ASKA will maintain cleanliness and operational standards conducive to State mandates for childcare centers.

Terms of Agreement
This agreement shall be in effect for:

months from the date of signing by the parties or until:

If a new agreement is not signed by the date and the child(ren) remains in care, the terms of this
agreement shall continue in effect until parent(s) and provider sign a new agreement.

Fees
The fee for care will be:
Fees are due on the FRIDAY before care to be provided.
$per
Payment Frequency
Other Fees Assessed

Late Pick-Up Fee (per occurrence) $2/minute
Late Payment Fee (per occurrence) $25/day late
Returned check Fee (per occurrence) $35/item

Trial Period
The first 1 week of care shall be a probationary period. During this period, either party may discontinue care with written notice. Termination of child care during this period will terminate this agreement. Parents/Guardians shall pay for days care was provided immediately due upon contract termination and within this week of trial.

Termination of Care
The parents/guardians and provider will make every effort to make the program work for each child, and to communicate and work together if there are concerns. Reason for termination of care include, but are not limited to:

  • Availability of resources to meet the child’s needs and parents/guardian’s willingness to access them.
  • Ability of ASKA to meet the child’s needs.
  • The impact of the child’s needs/behavior on ASKA.
  • Willingness of parents/guardians to work with ASKA.
  • Custody issues.
  • Failure of parents/guardians to fulfill their contractual agreement.
  • Late or non-payment of fees
  • Repetitive late pick-ups.

AGREEMENT BETWEEN THE PARTIES
By signing this contract, parents/guardians indicate that they have read the provider’s policies and agree to follow them. ASKA reserves the right to make changes to policies without notice. A failure to enforce one or more terms of the is contract does not waive ASKA’s right to enforce any other terms of this contract. In the event parents/guardians fail to pay the fees agreed to under this agreement, in addition to the right to termination of the provision of services, ASKA is entitled to recover the unpaid fees, together with reasonable attorney fees and costs
incurred in enforcing this agreement. Disputes will be subject to resolution in the Circuit or Small Claims Court, as applicable.

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Registration Form

Student(s)

Student Name
Student Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Country
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Parent/Gaurdian(s)

Name
Name
First
Last
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Emergency Contact(s)

Name
Name
First
Last
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Desired Weeks of Attendance
T-Shirt Size
What ASKA Offers to all our students…

❏ Staff who are trained in CPR/AED, Early Childhood course work, Emergency Safety Standards, Health &
Safety training, and all have valid fingerprinting and background checks completed.
❏ Regularly scheduled Karate Lessons with small class sizes.

REGISTRATION INFORMATION/DETAILS

Fee Information

Registration Fee (non-refundable) $100 Due at Registration T-Shirt included ($10 each add’l)
Weekly Tuition $235
Daily Tuition (drop-in only for 2
days a week or less)		 $60 Due the morning of drop-in
Six Flags Field Trip
Students without a Season Pass $45 Ticket cost and transportation fee

AFTER SCHOOL KARATE ACADEMY POLICIES & PROCEDURES

Daily Hours of Operation: M – F 7AM – 6:00PM

PAYMENT POLICY – Tuition and fees are due by the Friday preceding the week of attendance. If payments are not received on Friday, the account is subject to a $25 late penalty. If payment is not received by Monday at 12 noon (EST), I authorize ASKA to charge my bank account information on file (see signed agreement) CANCELLATION POLICY – Please note that we require a two (2) weeks advance notice of intention to cancel attendance for any reason in writing. You may send this notice to askabowie6950@gmail.com or provide a written notice in person to Hamid Shahraki.

BAD CHECK FEE - If your check for any payment under this contract is returned for any reason, the account is subject to a $35 surcharge or the maximum amount permitted by law, and when applicable, a late fee payment charge will be assessed as well as any other charges permitted by law.

PICK-UP TIMES – It is required to sign your child in and out each day. ASKA closes promptly at 6:00pm Monday through Friday. If you are unable to pick-up your child(ren) by the scheduled time, please let us know in advance, if possible. A late fee of $2 per minute will be assessed and is payable upon pick-up. If another person will pick-up your child(ren), contact us with the name of the individual and relationship to the child(ren). We will ask for valid ID for all individuals picking up your child(ren) and not listed on the Emergency Contacts list.

ASKA Code of Conduct – Please refer to the ASKA Code of Conduct addendum.

Release of Liability – Members and their guests attending the school and using any equipment, do so at their own risk. The institute shall not be liable for any damages arising from personal injuries sustained by members and guests, in, on, or about the premises of the institute. The institute assumes no responsibility for the loss of, or damage to, any personal property belonging to a member or guest while on the institute premises. Governing Law – This contract will be governed by the laws of the State of Maryland and the United States of America. If any part of this contract is unenforceable, this will not make any other part unenforceable. By signing this contract, you understand the policies and hereby agree to abide by all the policies and procedures.

Governing Law – This contract will be governed by the laws of the State of Maryland and the United States of America. If any part of this contract is unenforceable, this will not make any other part unenforceable. By signing this contract, you understand the policies and hereby agree to abide by all the policies and procedures.

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ASKA Code of Conduct

Karate Academy is committed to providing a safe, fun and learning environment by promoting respect, responsibility, discipline and excellence. As we know accidents and mistakes are prone to happen, therefore students will be guided to handle situations in a peaceful way. To ensure reaching these goals ASKA have set rules for students to follow. Students that react in disrespectful or violent manner will first be given verbal warnings.

Students that are given verbal warning but repeatedly offend with the same behaviors will be subject to the following disciplinary actions:

1st Offense – will result in a phone call to parent. No participation in group afternoon activities. Required to complete writing disciplinary assignment.

2nd Offense – will result in a phone call to parent for early dismissal. No participation in Friday activity or Parent’s Night Out.

3rd Offense – will result in early dismissal and parent conference or 1-day suspension from ASKA.

Final Offense – will result in parent conference and 2-days of suspension from ASKA. This may incur dismissal from ASKA Camp altogether with discretion upon the Director.

Please sign below to indicate you and your student(s) have read, understand and agree to the ASKA code of conduct.

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Transportation Permission Slip

I,grant ASKA permission to transport my child(ren) listed below with the commercial vehicles under the supervision of ASKA employees to and from varied activities while attending Summer Camp for the duration of time between June 24 – August 23, 2024.
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Child Information

Name
Name
First
Last
Car Seat Required
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*Please note ASKA does not provide a car seat and you will need to provide a car seat for travel if one isrequired.

Photo Release Authorization

I,grant ASKA permission to transport my child(ren) listed below with the commercial vehicles under the supervision of ASKA employees to and from varied activities while attending Summer Camp for the duration of time between June 24 – August 23, 2024.
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Youth Camp Health History

Child Information

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Country

Emergency Contact Information

Emergency Contact
Emergency Contact
First
Last
Second Emergency Contact
Second Emergency Contact
First
Last

Health Information

Are there any health problems including physical, psychiatric, or behavior problems of which we need to be aware?
Are there any medications, dietary restrictions, allergies, or special needs that we need to be aware of to ensure that your child's camp experience is positive?
For campers who currently reside within the United States, a United States territory, or the District of Columbia: Does the camper have any immunization exemptions because of a parental or guardian objection or medical contraindication?

For campers who reside outside the United States, a United States territory, or the District of Columbia: Attack record of vaccination or immunity on Department form MDH-896

File Uploads

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Maximum upload size: 8.39MB
Maximum upload size: 8.39MB
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Please submit payment in person to complete registration after submitting your application below