Karate

Karate is currently in session. Please contact John Wellman at 217-430-1399 for additional information before signing up.

Sessions on Wednesday and/or Fridays from 6:00 pm – 7:00 pm at St Dominic School.

 Open to girls and boys in 2nd through 8th grade
 $40 per participant for one 1 day a week
 $60 per participant for two 2 days a week
 8 week session

Karate

Participant First Name *

Participant Last Name *

Birthdate *

School *

Grade *

Email Address *

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Address *

City *

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Zip *

Emergency Contact Name *

Emergency Contact Number *

Name of Insurance Company *

Address of Insurance Company *

How would like to Pay your Registration Fee *

PayPal Registration *

By submitting this form I understand that Partcipation in any extracurricular activity or sport is a privilege and not an exclusive right according to the Catholic Youth Organization.
I also acknowledge that there are inherent risks associated and accompanied with sports and activities, and that my child may be injured as a result of an accident arising out of participation in athletics or activities.
Insurance Waiver
I also understand that my child must be covered by medical and/or accident insurance in order to participate in sports and hereby certify that my child is covered for injuries and/or death occurring as a result of participation in, or the practice for, all athletic events as in the Quincy Catholic Elementary Schools (St. Peter, St. Francis Solanus, St. Dominic, and Blessed Sacrament) CYO sports leagues during the current school year. I also certify that said insurance will be kept in force during the full time that my child engages in the practice for or participation in athletic events during the current school year.