PARKS TAEKWONDO CLUB at J.F.

BURNS ELEMENTARY
Session 1 (2014-15)
RSVP: Due October 29, 2014 (513) 469-7275

Who: Grades K & up (Free Uniform for All New Students.)

When: Mondays, 3:30 4:15 pm, for 8 weeks
Nov. 3, 10, 17, 24, Dec. 1, 8 &15
(CLASSES ARE TAUGHT BY MASTER PARK)

Where: Cafeteria
(please pack a small snack for your child.)

Pick-Up Time: 4:15 pm SHARP!

What: Learn; CONFIDENCE, SELF-CONTROL, RESPECT, FITNESS,
DISCIPLINE, TEAM WORK, POSITIVE ATTITUDE,
BULLY PREVENTION & MORE.

Registration: $105.00 (make a check payable to Parks TKD or put Credit Card Info below)
Or Sign-up over the phone by calling (513) 469-7275
Free Uniform for All New Students.
Need more info?? Call, PTO Contact, Janel Shepherd (513) 405-6761 or

Master Park (513)469-7275 Instructor is subject to change.
Please mail this portion to
Park's TaeKwonDo Club
8944 Columbia Rd Suite 700. Loveland, OH 45140


Students Name:____________________________________ Age:_____ Height/Weight:____________/______

Address:________________________________________ City:______________________ Zip:______________

Phone Number:___________________ Email:___________________________ Payment Type: Cash/Check/Card

Credit Card #:_______________________________________ Exp:__________ Type: MC / Visa / Dis

Emergency Contact Person:__________________________ Phone:____________________ Relation:__________

LIABILITY WAIVER
In consideration of your acceptance of my registration in this club, I do hereby, for myself, my heirs, executors and
administrators waive, release and forever discharge any and all rights and claims for damages which I may have against
Parks TaeKwonDo Training & Fitness, J.F. Burns Elementary, and all members of the J.F. Burns, Parks TaeKwonDo Club and
their respective officers, instructors, agents, representatives, successors, and/or assigns and against any students for any and
all damages which may be sustained by me in connection with my association with or entry in the above athletic meet, and
which may arise out of traveling to, participating in, and/or returning from such athletic class. I fully understand that
TaeKwonDo is a sport and that injuries can occur during practice. In the event this application is for a minor, I warrant and
represent that I am the parent or legal guardian of such applicant and that I waive any and all rights and claims for damages
claimed for students contained herein.

Parent Signature__________________________________________________Date________________________