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2011-2012 Premier Martial Arts After School Karate Program

GUIDELINES

Program Manager: Misty Vick Program Supervisor: 205.640.3166

Introduction
The purpose of the Premier Martial Arts After School Karate Program (ASKP) is to provide a quality and affordable
alternative to daycare for children 5-12 yrs old.

The After School Karate Program Provides:

Positive Learning Environment
Character Development Education through Martial Arts Training
A Supportive Environment

Moreover, it is the hope of the Premier Martial Arts After School Karate Program that the student will be enriched
because of their association with the Premier Martial Arts After School Karate Program. We care about each student
individually, being very careful not to compare, but appreciate the precious rhythm of each students growth. We do
not, in any way, attempt to replace the priority of the home and its environment, but rather seek to supplement and
enrich. Through the help and cooperation of all parents, this is possible.

Hours and Locations
The Premier Martial Arts After School Karate Program begins with the transportation of the students to the karate
school at the end of the formal school day and until after the childs karate classes, not to extend past 6pm. The
program begins the first day of school for students, public school calendar, and ends the last day children attend school.
Any time the school is closed for students, the Premier Martial Arts After School Karate Program is also closed. For the
2011-2012 school year, the Premier Martial Arts After School Karate Program will be held at Premier Martial Arts in
Moody, Alabama.
Enrollment Requirements
1. Only children ages 5-12 years of age who are currently enrolled in Premier Martial Arts Black Belt Training,
Premier Training, or Leadership Training and attend Moody Elementary, Moody Middle, Odenville Elementary,
Odenville Intermediate, and Odenville Middle will be accepted into the Premier Martial Arts After School Karate
Program. Students with fees owed to Premier Martial Arts or to the Premier Martial Arts After School Karate
Program may not enroll until their accounts are up to date or paid in full. Only children whose parents/legal
guardians have completed the following registration process may be considered for acceptance into the Premier
Martial Arts After School Karate Program:
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[ ] Emergency Information Form [ ] Discipline Policy Signature
[ ] Tuition Contract [ ] $50 Registration Fee
[ ] Registration Form [ ] Enrollment in BBT/PT/LT
2. When Premier Martial Arts After School Karate Program is at maximum capacity, parents may place their child(ren)
on a waiting list and be notified on a first-come, first-serve basis.
3. All children in the Premier Martial Arts After School Karate Program must have proof of full coverage insurance.
Fees
Participation in the Premier Martial Arts After School Karate Program costs $1,435.00 per child per school year. This fee
is due in ten equal payments of $143.50 with the first payment due August 15th and subsequent payments are due each
month thereafter through May 15
th
. The ASKP cost of $1435.00 is in addition to the normal Black Belt Training, Premier
Training, or Leadership Training programs.
Registration Fee: $50 non-refundable registration fee per family per school year is required at time of registration
Monthly Payments: 10 payments of $143.50 (Financing provided by Member Solutions.)
Weekly Payment: 41 payments of $35.00 (Financing provided by Member Solutions.)
Pay in Full - 15% discount $1220
- ASKP DOES NOT BILL, PRORATE, or accept ANY PAYMENTS AT THE ASKP SITES.
Payments will be collected by our billing company, Member Solutions, and will be either drafted from a checking or
savings account, or charged to a credit card. Pre-payments are encouraged and discounts will apply. A child will be
dismissed from the program after one week of nonpayment of fees. There is a $30 service charge for all returned
payments.

Behavior Expectations
Students are to obey the rules and policies governing school behavior, respect the authority of school personnel and act
in a morally responsible manner so as to bring honor to themselves and Premier Martial Arts. Students are also
instructed to display appropriate social skills by using courtesy and respect, coping with disagreements and criticism,
and accepting responsibilities for words and actions. Students should also demonstrate concern for learning by
completing homework, being neat and prepared, following directions, and staying on task.

Discipline
No corporal punishment shall be administered to any student. No punishment will be administered to any student that
will endanger the student in a physical manner or any manner that would cause illness or disease. If a student does not
observe the behavior expectations listed above, the ASKP staff will consecutively use the following methods of
discipline:

1. Give a Verbal Warning

2. Provide a Time Out: The student will be separated from the class for a period of minutes equal to their age.

3. Assign Sentences

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4. Notify Parent or Guardian

5. Issue a Behavior Notice

If the discipline methods listed above are not effective, or if a student intentionally causes injury to themselves or to
another student, a behavior notice will be automatically given. The notice will be filled out by ASKP staff detailing the
students behavior and given to the parent to sign. A copy of the signed Notice will then be given to the parent.

Please note the following:

Upon receiving 3 notices, a student is suspended from the program for 3 days.

Upon receiving 3 additional notices, a student WILL BE TERMINATED from the program without refund.

Students are expected to obey the rules:

Remain with assigned staff at all times.
Remain in designated ASKP areas.
Show respect for caregivers and other students.
Keep their hands to themselves, not touching others or others belongings.
Not use profanity or display obscene gestures.
Follow the rules and regulations of the Premier Martial Arts and ASKP.
Parents are expected to:
Direct all concerns to the attention of the Program Director.
Notify Premier Martial Arts if transportation changes for the day.
Not approach or discipline any child in our care.
Not use abusive language towards PMA staff or students.
Pick up child if notified for any reason.
Present picture ID, if requested.
Sign out child each day.
Pick up child by 6:00 p.m.
Be responsible for all fees, payable by due dates.
Provide all medical information, forms, and supplies.
(Students can be dismissed due to parents actions.)
It is imperative that parents and staff work together to establish a safe, structured environment.
Health and Medical Information

1. For the protection of all the children, no child will be admitted to the Premier Martial Arts After School Karate
Program while he/she has a fever, diarrhea, vomiting, a draining rash, eye discharge or pinkeye, lice or nits, to tired or ill
to participate in normal activities. We need your help in keeping contagious diseases such as colds and flu out of the
center. When your child is sick, you will be called to pick up your child as soon as possible.

2. Children should not be sent back to the Premier Martial Arts After School Karate Program for at least 24 hours after
they are clear of fever or symptoms. Children in attendance must be well enough to participate in all activities.

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3. School age children are not allowed to carry medication between the schools and the Premier Martial Arts. Please be
sure your child takes any afternoon medicines prior to leaving their school.

4. Accident/Injury Plan - If your child is injured at Premier Martial Arts, first aid will be administered. If treatment by a
doctor is necessary, we will make every effort to contact you and/or the doctor you have chosen to treat your child. In
the event of an emergency, we will make sure that your child receives necessary emergency treatment until we can
reach you. The authorization for emergency treatment on the enrollment form must be signed when you enroll.
Procedures:
The staff will notify parents of accident.
In case of serious accident or illness, EMS will be summoned for treatment (parents are responsible for bill).
An accident/injury report will be filled out, with a copy made for the file and a copy given to the parents.

Holiday and Inclement Weather Closings

The program will be closed on all days that school is not in session. When St. Clair County Schools are closed because of
inclement weather, etc., the Premier Martial Arts After School Karate Program will be cancelled. When St. Clair County
Schools close early due to inclement weather, the Premier Martial Arts After School Karate Program will be cancelled.
Tune into the radio and T.V. announcements during a time of crisis.
Grievance Procedures

Any problem regarding the Premier Martial Arts After School Karate Program should be discussed with the Program
Director. Please make an appointment so that the Program Director will be sure to have time to discuss the problem
with you privately.
Withdrawal Policy

Parents who wish to withdraw their children from the Premier Martial Arts After School Karate Program must notify the
school in writing 30 days before the day they are leaving. Fees will continue to draft within those 30 days and will
discontinue after that time. This policy only applies to the Premier Martial Arts After School Karate Program fees and
does not apply to the tuition fees for Premier Martial Arts.

Waiver and Release

I and my child(ren) fully recognize the risks of injury and/or illness inherent in participation in any fitness or martial arts
program, and we represent to the school that we have taken all reasonable steps to determine, and hereby warrant,
that we are in good health and physically capable of participating in the program and courses of instruction offered by
the school. We acknowledge that the School shall make no, and shall have no responsibility to make, any independent
evaluation of our physical health or fitness. We understand and agree that all participation in any such fitness program
or use of the Schools facilities or equipment on or off premises of the School, including field trips, shall be at our own
risk. We hereby release indemnity, and hold harmless the School and its officers, directors, employees and agents, from
and against any and all claims, demands, damages, costs and liabilities of any kind or nature, including attorneys fees
and costs, for injury to or death of myself or my child(ren), or of any person or persons who become entitled to use the
facilities of the School by virtue of our membership, or any third persons which arise directly or indirectly out of or in
connection with our participation in any program or course of instruction either on or off the premises of the School, or
by virtue of our presence at the School or at any of the Schools off-premises events, whether or not in fact we or such
other persons are then participating in any particular program or event. We understand and agree that the School shall
not be responsible for the conduct of other users of the School or its facilities or equipment, participants in the Schools
off-premises programs, or for any injury or death or damage to property resulting from such conduct. We shall not bring
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any action or proceeding against the School for any payment compensation or claim for any loss of life or injury by any
such user.

Additional Cost
We understand and agree that there will be special events, that are optional, held at the school, including but not
limited to, belt tests, tournaments, camps, Parents Night Out parties, sleep-overs, etc., and these events all incur
additional fees beyond the amounts set forth in the Agreement. We also understand and agree that the costs of
uniforms, equipment, supplies, and food items such as snacks, are not included in the costs set forth above, and must be
purchased separately.

Not a Day Care

I understand that the School is not a daycare facility but rather a Martial Arts School and that their intent is to teach the
physical, mental, and emotional skills of the Martial Arts. I acknowledge that my child must participate in the martial arts
classes daily and that if my child refuses to participate in classes that I will be contacted to come pick up my child. We
are not a day care and do not keep children that do not participate in classes.

Rules and Regulations

I and my child(ren) agree to abide by the rules and regulations governing the conduct and operation of the facilities. We
understand that the School has the right to alter or amend any or all rules and regulations, including those set forth in
this Agreement, and we agree to abide by all such amended rules and regulations. We acknowledge that we have been
provided with a copy of all current rules and regulations. We understand that our membership and the right to use the
Schools facilities and programs may be suspended or terminated at any time, with or without cause.

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I, ______________________ have read and understand all that I have read in this
handbook. I will abide by all the rules and regulations that have been outlined in
this handbook. I, furthermore, understand that the rules and regulations in this
handbook are subject to change and that I will be made aware of any and all
changes that may occur hereafter.

____________________ ________________
Parent/Guardian Signature Date

_____________________ ________________
Witness Date

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2011-2012 Premier Martial Arts After School Karate Program
Registration Form
Separate registration form for Each Child, a non-refundable registration fee must be authorized, all signatures must be present, and both sides of form must be filled out.)
Childs school site for 2011-2012 _______________________________________________________________________
Childs Full Name ____________________________________________________________ Grade for 11-12_________
Name to be called ____________________________________ Gender _____ Age _____ Birthdate ________________
Home Address _____________________________________________________________________________________
city______________________________________________________________________ zip_____________________
Mailing Address (if different) _______________________________________________________________________
city______________________________________________________________________ zip_____________________
Mothers Name: _________________________________________________________________________________
Home Phone #: ______________________________ Place of Work: ______________________________________
Work Phone #: _____________________________ Cell #: ________________________________________________
Email address: ____________________________________________________________________________________
Fathers Name: __________________________________________________________________________________
Home Phone #: ______________________________ Place of Work: ______________________________________
Work Phone #: _____________________________ Cell #: ________________________________________________
Email address: ____________________________________________________________________________________
Legal Guardians Name:______________________________________________________________________________
Home Phone #: ______________________________ Place of Work: ______________________________________
Work Phone #: _____________________________ Cell #: ________________________________________________
Email address: ____________________________________________________________________________________
Name(s) of custodial parent(s) _______________________________________________________________________
If Legal Guardian, what is your relationship to the child? __________________________________________________
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P I C K - U P I N F O R M A T I O N:
Please list persons, other than parent, who are authorized for pick-up, or who can be called in case of an emergency and
parent cannot be reached. Children will not be released to anyone who is not listed below.
NAME RELATIONSHIP PHONE
____________________________ ________________________ _______________________________
____________________________ ________________________ _______________________________
____________________________ ________________________ _______________________________
____________________________ ________________________ _______________________________
Please list anyone who is NOT permitted to pick-up your child: ______________________________________________
What is the relationship of this person to your child? ______________________________________________________
(PLEASE NOTE: Parental pick-up restrictions will require legal documentation to be on file.)
Please list any information regarding your child that the staff may need to know: _______________________________
_________________________________________________________________________________________________
Names, ages, & school/s of brothers/sisters attending Premier Martial Arts:
NAME AGE SCHOOL
____________________________ ________________________ _______________________________
____________________________ ________________________ _______________________________
____________________________ ________________________ _______________________________
____________________________ ________________________ _______________________________

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MEDICAL / EMERGENCY INFORMATION & RELEASE
ATTENTION PARENTS: It is imperative that all spaces below are filled. Registration is not complete if all spaces are not
filled in. Please use n/a if something does not apply to your child.
MEDICAL INFORMATION:
Medical Problems / Physical Activity Restrictions: ________________________________________________________
Allergies / Diet Restrictions: __________________________________________________________________________
Medications being taken: ____________________________________________________________________________
Doctors Name and Number: ________________________________________________________________________
Hospital preferred: _________________________________________________________________________________
Name of Insurance Company ____________________________________Policy No.____________________________
MEDICAL RELEASE and PARENT / GUARDIAN ACKNOWLEDGEMENT OF ASKP POLICIES, PROCEDURES, RULES &
REGULATIONS:
I have received, read, understand, and agree to be bound by the policies, procedures, and guidelines as stated in the
current years INFORMATION GUIDE. I understand the discipline policy, the payment procedures, and I understand that
my child will not be able to attend Premier Martial Arts After School Karate Program if fees are not received by due
dates.
In the event my child needs emergency or medical treatment, every attempt will be made to contact us, the
parent/guardian. In the event I/we cannot be contacted, my authorized signature below gives my/our permission to
Premier Martial Arts and/or Premier Martial Arts After School Karate Program staff to secure prompt treatment.
NOTE: Failure to sign does not relieve parent / guardian and / or student from compliance.
I understand and will comply with all Premier Martial Arts and/or Premier Martial Arts After School Karate Program
policies and procedures.
Signature ______________________________________________________ Date_____________________________

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Pictures and Video Permission Form

From time to time, Premier Martial Arts shoots video or takes photos of the
children in their normal activities in karate and the After School Program. These
photos may be used on our website or in advertising for these programs. We ask
that our parents release the use of such images by signing the form below.

I give Premier Martial Arts and the Premier Martial Arts After School Karate
Program permission to take pictures / video of my child, while engaged in normal
activities at Premier Martial Arts and the Premier Martial Arts After School Karate
Program. I understand these images may be used in advertising, on the website,
or for bulletin boards or other decoration within the school.

Parents Signature: ___________________________________Date:____________