Greater Napanee's Diamond Kids Camp
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2020 Diamond Summer Camp Agreement

Thank You! You have successfully signed and submitted your Camp Agreement

Please fill in all the required information. (*)

Enrollment Date Please select the camp weeks (You may select more than one week)





Source


1Camper Information

First Name* Last Name* DOB* Allergies Special Needs/Concerns:
2Parent Information

Parent #1
Full Name* Relationship to Child* Email Address* Cell Phone* Work Phone Address
Parent #2
First Name Last Name Relationship to Child Email Address Cell Phone Work Phone Address
3Emergency Contacts
(PLEASE PROVIDE TWO CONTACTS):
Contact #1
Full Name Relationship to Child Cell Phone Home Phone
Contact #2
Full Name Relationship to Child Cell Phone Home Phone
4Medical Consent
Health Card# Version Code
Family Doctor
Full Name Phone#
Dentist
Full Name Phone#

In the event of an accident, injury or illness involving a child, Diamond Fitness MMA. (herein “DFMMA”) will, as soon as possible, contact by telephone: (1) the parents or legal guardian, (2) the emergency contact listed above.

If DFMMA cannot immediately reach a parent/legal guardian or designated emergency contact, I hereby authorize DFMMA, its directors, managers and authorized employees to secure and, if necessary, consent to medical treatment for my child including without limitation, transportation and admission to an emergency clinic or hospital, administration of xrays, tests or treatment, medication or injections, anesthesia and/or surgery, as deemed necessary by the attending medical professional(s).


5Please list everyone who may be picking up your child on the lines below.
Name #1
Full Name Relationship
Name #2
Full Name Relationship
Name #3
Full Name Relationship
Name #4
Full Name Relationship

Diamond Fitness Mixed Martial Arts is always striving to offer you better service in every way possible. This year we will be taking steps to increase the overall safety of our program both on and off the mats. Only individuals listed below will be permitted to pick up your child(ren) from the Facility. If an individual not listed attempts to pick up your child, we will not release your child to them and you will be contacted immediately.
Furthermore, when you come to pick up your child you will need to sign your child out at the front desk and then a staff member will get your child from class and bring them to you. Parents will no longer be able to go on the mat or into our other rooms to retrieve their child.

1. To guarantee your child(ren) spot in the camp you must make full payment (unless discussed with management)

2. NO REFUNDS for the camp; If Diamond Fitness is required to close camps due to COVID-19 we will refund your money for remaining days that are missed.

3. I understand that Diamond Fitness Mixed Martial Arts, is a martial arts school and not a daycare in as such, their stock-in-trade is not supervision and care. The intent of Diamond Fitness Mixed Martial Arts is to teach martial arts, physical and philosophical character building skills. If my child(ren) stays at the Diamond Fitness Mixed Martial Arts facility it is because of my direction.

4. WAIVER & RELEASE: (Parents) Buyer and Camper(s) agree that Camper(s) is engaging in physical exercise, the use of equipment, and the use of Diamond Fitness Mixed Martial Arts training and instruction facility, which can be dangerous to the Camper(s) and could cause injury to Camper(s). Camper(s) is voluntarily participating in these activities and Buyer and Camper(s) assume all risks of injury to Camper. Buyer and Camper hereby waive and release any claim or right to sue Diamond Fitness Mixed Martial Arts, employees or agents for injury to Camper(s). Buyer and/or Camper have carefully read this waiver and release and fully understand, it is a release of all liabilities and damages to Diamond Fitness Mixed Martial Arts because of any injury that may occur. Diamond Fitness Mixed Martial Arts will make no evaluation or recommendation whether Camper(s) or guests are physically fit for any exercise activities. It is always advisable to consult your physician before undertaking a physical exercise program, particularly martial arts activities

5. LOSS/DAMAGE/THEFT OF CAMPER’S PROPERTY: Diamond Fitness Mixed Martial Arts does not assume any responsibility for the loss, damage or theft of any property belonging to the Camper and Camper agrees that the school and its personnel are not responsible for or liable for any such property even if its loss, damage, or theft occurs on or about the school’s facility.

6 .CONSENT TO USE PHOTOGRAPHIC, VIDEO RECORDINGS: I consent that photographs may be taken and video recordings may be made of my child by Diamond Fitness Mixed Martial Arts (DFMMA), its affiliated and related companies and each of their respective directors, officers, owners, employees, representatives and authorized agents (herein referred to as “Diamond Fitness Mixed Martial Arts (DFMMA)”) during my child’s participation in Diamond Fitness Mixed Martial Arts (DFMMA) activities. Such photographs and videos recordings may be used by Diamond Fitness Mixed Martial Arts (DFMMA) for current and future marketing activities and promotional materials. I AUTHORIZE Diamond Fitness Mixed Martial Arts (DFMMA) to use, reproduce, edit, alter, publish, transmit, distribute, broadcast and display photographs and video recordings that contain my child’s image, with or without his/her name associated with them, in any current or future promotional materials, in both print and electronic format, including, but not limited to: publications, videos, multimedia productions, CD, DVD, displays, posters, brochures, advertisements, newsletters, media coverage, souvenirs, and on its website or social media websites such as Facebook and YouTube, without further notice to me or without my approval of the finished photographs, videos or audio recordings.


6Parent Responsibility Checklist

7Signature
Signature Here Please



By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.