Summer Camp 2024 Registration

Registration Form 2024 | OKITO AMERICA SUMMER CAMP

Please ensure you read and complete all portions of this registration form.

Please enable JavaScript in your browser to complete this form.

Please Select Your Okito America Location *

If you have any questions feel free to call us! OA1 (352)-338-7262 | OA2 (352)-338-7262 | OA3 (386)-206-5486

Camper Name *

First

Last

Parent or Guardian 1 *

First

Last

Parent/Guardian 1 Telephone #

Parent/Guardian 1 Cell # *

Parent/Guardian 1 Email *

Parent/Guardian 2 Name *

First

Last

Parent/Guardian 2 Home Telephone #

Parent/Guardian 2 Cell # *

Mother

Parent/Guardian 2 Email *

Are there any special circumstances that the camp should be aware of relating to the family situation? *

Please note if there are special custody arrangements the camp must have all necessary paperwork on file in the camp office.

Address - Street *

City *

Zip *

EMERGENCY CONTACT - Name *

First

Last

Relationship *

Cell # *

If Billing Address is Different -Name

First

Last

Address - Street

City

Zip

Cell #

FEE SCHEDULE: Please Select Desired Session *

Half Day Session - $99/week (7:30 am to 12:30 pm) or (12:30 pm to 5:30 pm) *Field trips not included*
Full-Day Session - $179/week (7:30 am to 5:30 pm) * Field trips not included*
One-Day-Session - $49/day (3 days or more count as a week)
Full-Day & Field Trip Session - $194/week (7:30 am to 5:30 pm) *Field trips are held 2-3 times a week*
Cooking Class Session - $65/per class (classes are held once a week at our Alachua City location)
$15/week additional for Field Trip

If One-Day-Session was selected, Please list date(s)

Method of payment for deposit *

*DEPOSIT* ($50 Non-Refundable Registration per child must accompany registration form)

Method of payment *

*(A $15 Late fee will apply to all payments made after payment due date)*

Credit Card #

Expiration Date

Name on Card

CVC

ZIP

PLEASE INITIAL *

Full payment is required, there will be no refunds - no exceptions.

PARENT/GUARDIAN SIGNATURE *

You agree to use an electronic document and an electronic signature. You understand that electronic signatures are legally binding.

DATE *

A physician's examination is not required. Please Complete this information to the best of your knowledge. Please inform the camp office in writing of any changes to your child's health prior to their arrival at camp.

Camper Name *

First

Last

Age *

Birth date *

Health Card # *

Family Doctor *

Doctor Telephone # *

Allergies *

If Yes, Please List

Does This Allergy Require an Epi-Pen?

Medication *

If Yes, What Medication?

Please List Any Medication and doses that your camper will be taking at camp

Please note that all medication must be in its original container and all instructions attached.

Are there any activity restrictions while at camp? *

Are there any behavior/special considerations that the camp should know about to better facilitate their experience? *

Please read the following carefully and check off each item to ensure that your registration is processed correctly *

All Sections of the registration form must be completed
All forms must be accompanied by a $50 registration that is non-refundable
Please ensure that you have signed where indicated in the Parent's Authorization section
Please ensure that the camp has all appropriate information to help your camper have a successful stay
Any health information that changes, needs to be communicated to the camp IN WRITING before your child starts
I hearby give consent for my child to participate in the full Okito America program and all activities(inside and outside the facility during the duration of the 2024 Summer Camp) unless I advise you in writing.
I give permission for Okito America Day Camp to use any photograph my child is in for promotional material. To the best of my knowledge, my child is in good health, and I will notify the camp if he/she is exposed to any infectious diseases. I further release and agree to indemnify and hold harmless Okito America Summer Camp and its officers, servants or assigns from any liability concerning our child’s involvement in the Okito America programs and further agree that the use of all Okito America facilities is made at the risk of the registrant. In case of surgical emergency, I hereby give permission to the physician selected by the camp director, to hospitalize, to secure proper treatment for and to order injection, anesthesia, or surgery for my child, as named on this form. Every effort will be made to contact a parent/guardian in the case of emergency.
We are no responsible for any lost, broken, or stolen items
In case your child(ren) is (are) not feeling well, someone will need to pick him/her up to prevent other children from getting sick.
Registrations must be accompanied by a $50 Non-Refundable Deposit per camper.
Full payment is required before the attending week, and there will be NO refunds for any payment.
I understand that the Camp Administration reserves the right to dismiss a camper who, in their opinion, is a hazard to the safety or rights of others, or who appears to have rejected the reasonable expectations of the Camp.
Charges will appear on your statement under the name OKITO AMERICA
Outstanding balances after the 2024 summer camp ends will be charged interest of 1% per month.
A taekwondo uniform will be providing for only new full-time students attending more than a week.

PLEASE INITIAL: *

I agree and understand to the best of my knowledge all points stated above in Checklist

CAMP WEEKS: Please check the boxes next to which weeks your child will be attending camp *

JUNE 3 - JUNE 7 Week 1
JUNE 10 – JUNE 14 Week 2
JUNE 17 – JUNE 21 Week 3
JUNE 24 – JUNE 28 Week 4
JULY 1 – JULY 5 Week 5 (Okito America will be closed on July 4th)
JULY 8- JULY 12 Week 6
JULY 15- JULY 19 Week 7
JULY 22- JULY 26 Week 8
JULY 29 – AUGUST 2 Week 9
AUGUST 5 – AUGUST 7 Week 10 (Okito America will be closed Aug. 8th- 9th)

Please make sure the dates you selected are correct

Parent/Guardian Signature *

You agree to use an electronic document and an electronic signature. You understand that electronic signatures are legally binding.

Date *

Please enable JavaScript in your browser to complete this form.

Please Select Your Okito America Location *

If you have any questions feel free to call us! OA1 (352)-338-7262 | OA2 (352)-338-7262 | OA3 (386)-206-5486

Camper Name *

First

Last

Parent or Guardian 1 *

First

Last

Parent/Guardian 1 Telephone #

Parent/Guardian 1 Cell # *

Parent/Guardian 1 Email *

Parent/Guardian 2 Name *

First

Last

Parent/Guardian 2 Home Telephone #

Parent/Guardian 2 Cell # *

Mother

Parent/Guardian 2 Email *

Are there any special circumstances that the camp should be aware of relating to the family situation? *

Please note if there are special custody arrangements the camp must have all necessary paperwork on file in the camp office.

Address – Street *

City *

Zip *

EMERGENCY CONTACT – Name *

First

Last

Relationship *

Cell # *

If Billing Address is Different -Name

First

Last

Address – Street

City

Zip

Cell #

FEE SCHEDULE: Please Select Desired Session *

Half Day Session – $99/week (7:30 am to 12:30 pm) or (12:30 pm to 5:30 pm) *Field trips not included*
Full-Day Session – $179/week (7:30 am to 5:30 pm) * Field trips not included*
One-Day-Session – $49/day (3 days or more count as a week)
Full-Day & Field Trip Session – $194/week (7:30 am to 5:30 pm) *Field trips are held 2-3 times a week*
Cooking Class Session – $65/per class (classes are held once a week at our Alachua City location)
$15/week additional for Field Trip

If One-Day-Session was selected, Please list date(s)

Method of payment for deposit *

*DEPOSIT* ($50 Non-Refundable Registration per child must accompany registration form)

Method of payment *

*(A $15 Late fee will apply to all payments made after payment due date)*

Credit Card #

Expiration Date

Name on Card

CVC

ZIP

PLEASE INITIAL *

Full payment is required, there will be no refunds – no exceptions.

PARENT/GUARDIAN SIGNATURE *

You agree to use an electronic document and an electronic signature. You understand that electronic signatures are legally binding.

DATE *

Camper Name *

First

Last

Age *

Birth date *

Health Card # *

Family Doctor *

Doctor Telephone # *

Allergies *

If Yes, Please List

Does This Allergy Require an Epi-Pen?

Medication *

If Yes, What Medication?

Please List Any Medication and doses that your camper will be taking at camp

Please note that all medication must be in its original container and all instructions attached.

Are there any activity restrictions while at camp? *

Are there any behavior/special considerations that the camp should know about to better facilitate their experience? *

Please read the following carefully and check off each item to ensure that your registration is processed correctly *

All Sections of the registration form must be completed
All forms must be accompanied by a $50 registration that is non-refundable
Please ensure that you have signed where indicated in the Parent’s Authorization section
Please ensure that the camp has all appropriate information to help your camper have a successful stay
Any health information that changes, needs to be communicated to the camp IN WRITING before your child starts
I hearby give consent for my child to participate in the full Okito America program and all activities(inside and outside the facility during the duration of the 2024 Summer Camp) unless I advise you in writing.
I give permission for Okito America Day Camp to use any photograph my child is in for promotional material. To the best of my knowledge, my child is in good health, and I will notify the camp if he/she is exposed to any infectious diseases. I further release and agree to indemnify and hold harmless Okito America Summer Camp and its officers, servants or assigns from any liability concerning our child’s involvement in the Okito America programs and further agree that the use of all Okito America facilities is made at the risk of the registrant. In case of surgical emergency, I hereby give permission to the physician selected by the camp director, to hospitalize, to secure proper treatment for and to order injection, anesthesia, or surgery for my child, as named on this form. Every effort will be made to contact a parent/guardian in the case of emergency.
We are no responsible for any lost, broken, or stolen items
In case your child(ren) is (are) not feeling well, someone will need to pick him/her up to prevent other children from getting sick.
Registrations must be accompanied by a $50 Non-Refundable Deposit per camper.
Full payment is required before the attending week, and there will be NO refunds for any payment.
I understand that the Camp Administration reserves the right to dismiss a camper who, in their opinion, is a hazard to the safety or rights of others, or who appears to have rejected the reasonable expectations of the Camp.
Charges will appear on your statement under the name OKITO AMERICA
Outstanding balances after the 2024 summer camp ends will be charged interest of 1% per month.
A taekwondo uniform will be providing for only new full-time students attending more than a week.

PLEASE INITIAL: *

I agree and understand to the best of my knowledge all points stated above in Checklist

CAMP WEEKS: Please check the boxes next to which weeks your child will be attending camp *

JUNE 3 – JUNE 7 Week 1
JUNE 10 – JUNE 14 Week 2
JUNE 17 – JUNE 21 Week 3
JUNE 24 – JUNE 28 Week 4
JULY 1 – JULY 5 Week 5 (Okito America will be closed on July 4th)
JULY 8- JULY 12 Week 6
JULY 15- JULY 19 Week 7
JULY 22- JULY 26 Week 8
JULY 29 – AUGUST 2 Week 9
AUGUST 5 – AUGUST 7 Week 10 (Okito America will be closed Aug. 8th- 9th)

Please make sure the dates you selected are correct

Parent/Guardian Signature *

You agree to use an electronic document and an electronic signature. You understand that electronic signatures are legally binding.

Date *