Last Name*
First Name*
Date of Birth*
Age*
Gender*
MaleFemale
Parent's E-mail*
Home Address*
Province*
Postal*
Home Phone*
Custody
BothMotherFather
Child Resides With
Are you a single parent?: YesNo
You are a: MotherFather
Mother's Full Name
Phone
Home Address: Different from above
Work Address
Work Phone
Cell Phone
Father's Full Name
>
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: Yes
Name (Contact Person #2)
Address
Relation to Child
Other person authorized to pick up my child and relationship
Family Physician Name*
Physician Phone*
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?*
YesNo
If No, why?
Does your child require after school pickup?* YesNo
School*
—Please choose an option—Anson Park Public School - 30 Macduff Crescent, Scarborough, ON M1M 1X5Balmy Beach Community School - 14 Pine Ave, Toronto, ON M4E 1L6Beaches Alternative Junior School - 50 Swanwick Ave, Toronto, ON M4E 1Z5Beacon of Light Private Elementary School - 2191 Gerrard St E front office, Toronto, ON M4E 2C6Birch Cliff Heights Public School - 120 Highview Ave, Scarborough, ON M1N 2J1Birch Cliff Public School - 1650 Kingston Rd, Scarborough, ON M1N 1S2Blantyre Public School - Primary school · 290 Blantyre AveClairlea Public School - 25 Rosalind CrescentCliffside Public School - 27 E Haven Dr, Scarborough, ON M1N 1M1Chine Drive Public School - 51 Chine Dr, Scarborough, ON M1M 2K8Courcelette Public School - Primary school · 100 Fallingbrook RdCrescent Town Elementary School - Elementary school · 4 Massey SquareDanforth Gardens Public School - 20 Santamonica Blvd, Scarborough, ON M1L 4H4Fairmount Public School - 31 Sloley Rd, Scarborough, ON M1M 1C7General Brock Public School - 140 Chestnut Crescent, Scarborough, ON M1L 1Y5George Webster Elementary School - Elementary school · 50 Chapman AveGeorge Webster South - 90 Balfour Ave, Toronto, ON M4C 1T6Glen Ravine Junior Public School - 11 Gadsby Dr, Scarborough, ON M1K 4V4Immaculate Heart of Mary Catholic School - Catholic school · 101 Birchmount RdJ G Workman Public School - 487 Birchmount Rd, Scarborough, ON M1K 1N7John A. Leslie Public School - 459 Midland Ave, Scarborough, ON M1N 4A7Kimberley Junior Public School - 50 Swanwick Ave, Toronto, ON M4E 1Z5Lord Roberts Junior Public School - 165 Lord Roberts Dr, Scarborough, ON M1K 3W5Norman Cook Junior Public School - 725 Danforth Rd, Scarborough, ON M1K 1G4Norway Junior Public School - 390 Kingston Rd, Toronto, ON M4L 1T9Oakridge Junior Public School - 110 Byng Ave, Scarborough, ON M1L 3P1Our Lady of Fatima Catholic School - 3176 St Clair Ave E, Scarborough, ON M1L 1V6Samuel Hearne Middle School - 21 Newport Ave, Scarborough, ON M1L 4N7St. Albert Separate School - 1125 Midland Ave, Scarborough, ON M1K 4H2St. Denis Catholic School - 67 Balsam Ave, Toronto, ON M4E 3B8St. Dunstan Catholic School - Primary school · 14 Pharmacy AveSt Joachim Elementary School - Elementary school · 3395. St Clair Ave ESt. John Catholic School - 780 Kingston Rd, Toronto, ON M4E 1R7St. Theresa Shrine Catholic School - 2559 Kingston Rd, Scarborough, ON M1M 1M1Secord Public School - Elementary school · 101 Barrington AveTaylor Creek Public School - Elementary school · 644 Warden AveVictoria Park Public School - Elementary school · 145 Tiago AveWilliamson Road Junior Public School - 24 Williamson Rd, Toronto, ON M4E 1K5William J McCordic School - 45 Balfour Ave, Toronto, ON M4C 1T4
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.
I understand that photographs and/or video taken during the programs may be used in promotional material and I hereby consent to such use by Royal Taekwondo.
18 years of age or older?*
You or your child's age*
Primary E-mail*
Postal Code*
Should an emergency occur, please give the name, address and telephone number of a friend or relative. Please provide two emergency contacts. If at any time emergency medical treatment is necessary, I give my consent for it to be given. I understand that every effort will be made to contact the parents and/or the emergency persons listed.
Name (Contact Person #1)*
Relation to student*
Relation to the student
Other person authorized
Physician's Phone #
We want your experience to be the best it can be! Please help us by listing any and all relevant social and health concerns or conditions.
Check all that apply*
Taekwondo ProgramPerformance TaekwondoUltimate TaekwondoSingle Day Drop-InRoyal Knights Olympic TeamHigh Intensity CardioSummer CampMarch Break CampHoliday CampParties
I, the undersigned, hereby agree as follows:
I agree that the information provided above is true and accurate to the best of my knowledge.
I have reviewed and agree with the Terms of Service found here.
I understand that photographs and/or video taken during the programs may be used in promotional material and that programs/classes are broadcast via the internet and I hereby consent to such use by Royal Taekwondo.
Student Resides With
Mother's Full Name*
Work Address*
Work Phone*
Cell Phone*
Father's Full Name*
Relation to student
Physician's Phone*
Have you been immunized as required by Education Act?:
If No, why?*
Taekwondo ProgramRoyal Knights Olympic TeamHigh Intensity CardioSummer CampMarch Break CampHoliday Camp