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.

    • 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.

      Student's Information

      Last Name*

      First Name*

      Date of Birth*

      18 years of age or older?*

      You or your child's age*

      Gender*

      Primary E-mail*

      Home Address*

      Province*

      Postal Code*

      Home Phone*

      Emergency Contacts

      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)*

      Address*

      Phone*

      Relation to student*

      Another contact:

      Name (Contact Person #2)

      Address

      Phone

      Relation to the student

      Other person authorized

      Address

      Phone*

      Family Physician Name*

      Physician's Phone #

      Personal Data

      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.

      Social

      Health

      Medications

      Allergies

      Programs

      Check all that apply*

      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.

      Custody

      Custody

      Student 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 student*

      Another contact:

      Name (Contact Person #2)

      Address

      Phone

      Relation to student

      Other person authorized to pick up my child and relationship

      Address

      Phone

      Family Physician Name*

      Physician's Phone*

      Personal Data

      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.

      Social

      Health

      Medications

      Allergies

      Have you been immunized as required by Education Act?:

      If No, why?*

      Programs

      Check all that apply*

      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.

      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.

        • 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.

        General Signup

          Student's Information

          Last Name*

          First Name*

          Date of Birth*

          18 years of age or older?*

          You or your child's age*

          Gender*

          Primary E-mail*

          Home Address*

          Province*

          Postal Code*

          Home Phone*

          Emergency Contacts

          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)*

          Address*

          Phone*

          Relation to student*

          Another contact:

          Name (Contact Person #2)

          Address

          Phone

          Relation to the student

          Other person authorized

          Address

          Phone*

          Family Physician Name*

          Physician's Phone #

          Personal Data

          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.

          Social

          Health

          Medications

          Allergies

          Programs

          Check all that apply*

          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.

          Custody

          Custody

          Student 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 student*

          Another contact:

          Name (Contact Person #2)

          Address

          Phone

          Relation to student

          Other person authorized to pick up my child and relationship

          Address

          Phone

          Family Physician Name*

          Physician's Phone*

          Personal Data

          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.

          Social

          Health

          Medications

          Allergies

          Have you been immunized as required by Education Act?:

          If No, why?*

          Programs

          Check all that apply*

          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.