New Family Enrollment

Start your family enrollment

Tell us about your family. You can enroll one or more children at once — an instructor will follow up to schedule first classes.

Parent / Guardian

Full name*

Email*

Phone*

Place of employment

Street address

City

State

ZIP

Second parent / guardian (optional)

Full name

Phone

Place of employment

Student

First name*

Last name*

Date of birth*

Grade

Gender

School

Program interest

Allergies

Medical notes

Notes about this child

Kim Brothers staff will assign each child's official program, class schedule, and belt level after reviewing your enrollment.

Emergency contacts (apply to all children)

Authorized pickup people (apply to all children)

How did you hear about us?

Referral source

Agreements

These agreements are with Masterpiece Tae Kwon Do Inc., operating as Kim Brothers Tae Kwon Do. Each is recorded separately with your printed name and the date you accepted it.

Assumption of RiskRequired

I understand that Tae Kwon Do and the After School Program involve inherent risks of injury that cannot be eliminated. These include, without limitation: falls; collisions with other participants, floors, walls, or equipment; strikes, kicks, and blocks received during instruction, drills, sparring, and belt testing; sprains, strains, fractures, joint and ligament injury; concussion and other head injury; heat illness; injury during physical conditioning, games, or field trips; injury during transportation in a motor vehicle; and injury caused by the conduct of other participants. I knowingly and voluntarily assume all such risks, whether known or unknown, and I represent that my child is physically fit to participate.

I have read and agree to the Assumption of Risk*

Release of LiabilityRequired

In consideration of my child's participation, I, on behalf of myself, my heirs, executors, administrators, and assigns, hereby waive, release, and forever discharge Masterpiece Tae Kwon Do Inc., operating as Kim Brothers Tae Kwon Do, together with its owners, officers, instructors, employees, volunteers, and agents, from any and all claims, demands, actions, and causes of action for personal injury, death, or property damage arising out of or relating to my child's participation, to the fullest extent permitted by Georgia law. I understand this release does not apply to gross negligence or willful misconduct.

I have read and agree to the Release of Liability*

IndemnificationRequired

I agree to indemnify, defend, and hold harmless the released parties from any claim, loss, cost, damage, or expense, including reasonable attorneys' fees, brought by me or on behalf of my child arising out of my child's participation, to the fullest extent permitted by Georgia law.

I have read and agree to the Indemnification*

Medical Authorization and Financial ResponsibilityRequired

I authorize Kim Brothers Tae Kwon Do staff to obtain emergency medical treatment for my child if I cannot be reached, and I consent to staff or associated personnel rendering first aid. I accept full financial responsibility for all medical assistance, treatment, and transport, and I confirm the medical information provided in this enrollment is accurate and current.

I have read and agree to the Medical Authorization and Financial Responsibility*

Licensing DisclosureRequired

I have been informed and understand that this program is NOT licensed by Bright from the Start: Georgia Department of Early Care and Learning.

I have read and agree to the Licensing Disclosure*

Authority, Governing Law, and SeverabilityRequired

I represent that I am the parent or legal guardian with authority to sign on behalf of my child. I have read this agreement in full, I understand I am giving up substantial legal rights, and I sign voluntarily and without inducement. This agreement is governed by Georgia law. If any provision is held unenforceable, the remaining provisions continue in full force. I understand enrollment fees and tuition are non-refundable.

I have read and agree to the Authority, Governing Law, and Severability*

Photo and Media ReleaseOptional

I grant permission for photographs and video of my child taken during classes, events, and activities to be used by Kim Brothers Tae Kwon Do for promotional purposes including social media, website, and printed materials, without compensation.

I have read and agree to the Photo and Media Release

Text Message UpdatesOptional

I agree to receive text messages from Kim Brothers Tae Kwon Do about closures, schedule changes, and program updates. Message and data rates may apply. Reply STOP to opt out.

I have read and agree to the Text Message Updates

Signed by (printed name)*

Family notes (optional)

Anything else we should know?

Still required: Assumption of Risk, Release of Liability, Indemnification, Medical Authorization and Financial Responsibility, Licensing Disclosure, Authority, Governing Law, and Severability