After School at Meadowside Elementary School

This dynamic and energetic after-school program benefits children in a number of ways. They will engage in various Martial Arts techniques and activities, while learning important skills such as discipline, focus, self-control, confidence -- the list goes on! Sign up today!

  • Who: Any students in grades K-5 attending MeadowsideElementary School
  • Day:Tuesday or Friday
  • When:5 classes:Tuesday-9/26, 10/03, 10/10, 10/17, 10/24

Friday –9/29, 10/06, 10/13, 10/20, 10/27

  • Time:3:30 to 4:15 p.m. Parents— Please be prompt with pick-up!
  • Price: $50 for all students - new students will receive a white belt and Karate Club t-shirt
  • IF YOU SIGN UP FOR BOTH TUES & FRI SESSIONS YOU RECEIVE $10 OFF = $90 TOTAL FOR BOTH SESSIONS!
  • Registration & Payment: Return to your child’s teacher no later thanMonSept25.

Please make checks payable to Adam Rylski or pay by cash in a sealed envelope.

Students have the opportunity to earn higher-ranking belts as their participation in the Karate Club continues. This after-school program is sponsored by the PTA and a portion of the registration fees will be donated to the PTA. Please complete and detach the form below and sign waiver on back.

Return with payment by above due date and retain top portion for your information 

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Meadowside Elementary After School Karate:

PARENTS MUST CIRCLE SESSION(S) BEING TAKEN:

TUESDAY:9/26, 10/03, 10/10, 10/17, 10/24

FRIDAY:9/29, 10/06, 10/13, 10/20, 10/27

Student Name ______Grade _____ Room#/Teacher ______

Address ______Home Phone# ______

Parent/Guardian Name & Best Contact Phone# ______

Parent/Guardian Email Address: ______

Name/Phone# of person picking up child if different from above ______

Allergies and/or health concerns instructors should know about______

*Sign waiver on back*

INFORMED CONSENT/WAIVER OF LIABILTY

This Document is a release of liability. Please read it carefully.

1. You acknowledge that you will assume the risk of and release and hold harmless MeadowsideSchool and Adam Rylski or any of its officers or agents any liability for any injury or harm suffered by your child during or as a consequence or participating in this fitness program.

2. You agree to be responsible for any or all costs, damages or expenses incurred by you as a result of any injury sustained by your child from participating in this fitness program and further agree not hold Meadowside School, Adam Rylski or any agent responsible for any such in jury to your child.

3. You agree that if your child has any known physical limitation, including, but not limited to, asthmatic conditions, that you will be responsible for administering medication, if needed, and agree not to hold Meadowside School, Adam Rylski, or any agent responsible for such administration.

I, ______, parent/guardian of ______,

have read and fully understand the above.

______

Parent/Guardian Signature Date