Registration Form

    Child's Information
    Last Name*
    First Name*
    Date of Birth*
    Age*
    Gender*
    Parent's E-mail*
    Home Address*
    Province*
    Postal*
    Home Phone*

    Custody
    Custody
    Child Resides With

    Parent Information

    Are you a single parent?:

    You are a:

    Single Parent: Mother's Information
    Mother's Full Name
    Phone
    Home Address:
    Work Address
    Work Phone
    Cell Phone

    Single Parent: Father's Information
    Father's Full Name
    Phone
    Home Address:
    Work Address
    Work Phone
    Cell Phone

    Mother's Information
    Mother's Full Name
    Phone
    Home Address:
    Work Address
    Work Phone
    Cell Phone

    Father's Information
    Father's Full Name
    Phone
    Home Address:
    Work Address
    Work Phone
    Cell Phone

    Emergency Contacts
    Should an emergency occur and you cannot be reached, please give the name, address and telephone number of a friend or relative who would assume responsibility for your child. Please provide two emergency contacts. If at any time emergency medical treatment is necessary for my child, I give my consent for it to be given. I understand that every effort will be made to the contact the parents and/or the emergency persons listed.
    Name* (Contact Person #1)
    Address*
    Phone*
    Relation to Child*
    Another contact:
    Name (Contact Person #2)
    Address
    Phone
    Relation to Child
    Other person authorized to pick up my child and relationship
    Address
    Phone
    Family Physician Name*
    Physician Phone*

    Personal Data
    We want your child's experience to be the best it can be! Please help us by listing any and all relevant social and health concerns or conditions.
    Social
    Health
    Medications
    Allergies
    Has your child been immunized as required by the Education Act?*
    If No, why?
    Does your child require after school pickup?*
    School & Pick-up Details
    School*
    Pickup location & details*
    Pick up start date?*
    Pick-up time*
    Days required for pick-up*
    MondayTuedayWednesdayThursdayFriday

    In registering I am permitting my child to attend Royal Taekwondo programs. I the undersigned parent, guardian or other duty authorized party hereby agree as follows:

    • To permit my child to participate in the full range of activities.
    • I agree to let my child go on supervised excursions outside the Royal Taekwondo facility.

    After School

      Child's Information
      Last Name*
      First Name*
      Date of Birth*
      Age*
      Gender*
      Parent's E-mail*
      Home Address*
      Province*
      Postal*
      Home Phone*

      Custody
      Custody
      Child Resides With

      Parent Information

      Are you a single parent?:

      You are a:

      Single Parent: Mother's Information
      Mother's Full Name
      Phone
      Home Address:
      Work Address
      Work Phone
      Cell Phone

      Single Parent: Father's Information
      Father's Full Name
      Phone
      Home Address:
      Work Address
      Work Phone
      Cell Phone

      Mother's Information
      Mother's Full Name
      Phone
      Home Address:
      Work Address
      Work Phone
      Cell Phone

      Father's Information
      Father's Full Name
      Phone
      Home Address:
      Work Address
      Work Phone
      Cell Phone

      Emergency Contacts
      Should an emergency occur and you cannot be reached, please give the name, address and telephone number of a friend or relative who would assume responsibility for your child. Please provide two emergency contacts. If at any time emergency medical treatment is necessary for my child, I give my consent for it to be given. I understand that every effort will be made to the contact the parents and/or the emergency persons listed.
      Name* (Contact Person #1)
      Address*
      Phone*
      Relation to Child*
      Another contact:
      Name (Contact Person #2)
      Address
      Phone
      Relation to Child
      Other person authorized to pick up my child and relationship
      Address
      Phone
      Family Physician Name*
      Physician Phone*

      Personal Data
      We want your child's experience to be the best it can be! Please help us by listing any and all relevant social and health concerns or conditions.
      Social
      Health
      Medications
      Allergies
      Has your child been immunized as required by the Education Act?*
      If No, why?
      Does your child require after school pickup?*
      School & Pick-up Details
      School*
      Pickup location & details*
      Pick up start date?*
      Pick-up time*
      Days required for pick-up*
      MondayTuedayWednesdayThursdayFriday

      In registering I am permitting my child to attend Royal Taekwondo programs. I the undersigned parent, guardian or other duty authorized party hereby agree as follows:

      • To permit my child to participate in the full range of activities.
      • I agree to let my child go on supervised excursions outside the Royal Taekwondo facility.