Camp Registration Form

Use this form to register for our Camps

Tai Chi & Chi Kung Camp - August 10 - 12
Tai Chi & Chi Kung Camp - August 15 - 18th
Kid's Kung fu Power Camp - August 15 - 18th (Ages 6+)
Kung Fu & Tai Chi combo Camp - August 15- 18
Adult Kung Fu Power Camp August 15 - 18th

What dates would you like to attend camp?

Day camp or overnight? DayOvernight

If you are staying overnight, are you camping or do you need a cabin? CampingCabin

Number of Nights (1-15):

Your Name

Your Email

Phone

Address (including zip code):

Birthday:

Emergency Contact Name:

Emergency Contact Phone Nummber:

Emergency Contact Relationship:

Yes, I would like to purchase lunches.No, I would not like to purchase lunches.

Do you have any dietary restrictions or allergies?

Health

Please indicate your general health or any health concerns you may have:

What do you hope to gain from this program?

Previous Martial Arts or fitness experience?

How did you find out about Temple Knights?

Occupation?

Would you like to receive our monthly email newsletter?
YesNo

Waiver:

By submitting this registration form I certify that the above information is correct. As a participant I acknowledge that Temple Knights and their representatives shall in no form be liable or responsible for injury or bodily harm occurring to me during classes and that such risks shall be borne by myself voluntarily. Our policy after registration is no refunds. Make up classes, credit for unused classes or credit transfers are possible. Signature or signature of guardian will be required. Thank you.