Oops! Missing Fieldset

If you are seeing this message, it means you need to add a Fieldset to the beginning of your form. Your form may not function or display properly without one.

    Camper Information

  • Weekly Field Trip Admission and Friday Pizza Party Are Included in the Camp Fee.
  • Parent/Guardian Information

  • Emergency Contact Information

  • Camp Information

  • I hereby voluntarily submit my application for my attendance and participation to Agape Black Belt Center, LLC and hereby assume all responsibilities for any and all damages, injuries or losses I may sustain or incur while attending and participating. I hereby release and waive all claims against the sponsors, promoters, organizers, operators, host, instructors, associations, schools, owners, officers, directors, employees and other participants connected with Agape Black Belt Center, LLC individually or otherwise. I fully understand that in case of injury the only medical treatment provided will be first aid. I understand that I must strictly obey instructors and observe safety rules. I further agree that any photography and video taping of me in connection with Agape Black Belt Center, LLC can be used for publication, promotion, articles, and advertisements without additional consent and without compensation at this time or any other time. I understand that all registration fees are non-refundable.
 

Verification

Want to learn more about our programs?

Sign up today to receive news on up and coming programs and schedule updates!