2026 Summer Sports Camp Registration

PHYSICIAN VERIFICATION: I {first_name} certify that no coach, doctor, nurse, athletic trainer, or other person has advised me, or the minor participant named below, not to participate in the activities conducted at T Elite Martial Arts, LLC. My physician has examined me, or the minor participant named below, and certified that I or the minor participant named below am in good physical condition and have no disease or injury that would impair my performance or physical condition in training for or participating in the T Elite Martial Arts, LLC. I recognize that if I have any existing injuries that may affect my performance, I cannot participate in the T Elite Martial Arts, LLC without a report from my physician authorizing my participation, and I verify that if I have any such injuries, the requisite report is attached to this form.

AUTHORIZATION FOR MEDICAL TREATMENT: Further, in the event I, or the minor participant named below, am injured during my participation in the T Elite Martial Arts, LLC activities, I, {first_name} or the parent(s) and/or legal guardian(s) of the minor participant named below, hereby grant permission to any and all of the licensed athletic trainers, emergency medical technicians, nurses or doctors to provide me with medical assistance and treatment and, if needed, to transport me to a hospital or other treatment facility. For myself and for my heirs, children, parents, guardians, executors, personal representatives, administrators, successors and assigns, I forever release, acquit, waive, discharge, and covenant not to sue the T Elite Martial Arts, LLC, or any of the organizers, volunteers, sponsors, affiliated organizations, coaches, instructors, managers, athletic trainers, emergency medical technicians, nurses or doctors, or any other persons involved any injury I sustain or suffer in connection with T Elite Martial Arts, LLC or said medical assistance or treatment. I accept responsibility to pay for any and all financial obligations incurred as a result of any medical assistance or treatment provided in connection with any injuries or illness that I may sustain in the T Elite Martial Arts, LLC.

PHOTOGRAPHY, VIDEO, AND PROMOTIONAL RELEASE: For myself, or the minor participant named below, and for my heirs, children, parents, guardians, executors, personal representatives, administrators, successors and assigns, I, or the parents and/or legal guardian(s) of the minor participant named below, hereby give permission and authorization to T Elite Martial Arts, LLC and its designees, agents and applicable media vendors to use and reproduce any still photographs, videotape or any other media form that include my name or likeness, or the name or likeness of the minor participant names below, and use or reproduce any recording or other media form that includes my voice, in any approved T Elite Martial Arts, LLC publication, Website, podcast, audio recording, promotional materials, video medium (including but not limited to video clips) or any other medium. The undersigned releases and hold harmless the T Elite Martial Arts, LLC, and their designees, agents, and applicable media vendors from any and all claims of libel, slander, invasion of the right of privacy or publicity, or any other claim based on the use of my name, likeness or voice, and any and all damages, costs and expenses that may directly or in directly arise from the use of my name, likeness or voice.

TERMINATION OF PARTICIPATION: I, or the parents and/or legal guardian(s) of the minor participant named below, understand, and agree to abide by all policies, rules, and regulations. Participant understands that, in its sole discretion, the T Elite Martial Arts, LLC program or its representative may terminate my or the minor participant named below participation at any time should my actions or general behavior impede the operation of the T ELITE MARTIAL ARTS, LLC or the rights or welfare of any person. Reasons for termination may include but are not limited to inappropriate conduct or other behavior by myself or the minor participant named below deemed detrimental to the best interests of the T Elite Martial Arts, LLC such as persistent use of vulgar or inappropriate language; physical violence; emergencies; or health or safety considerations.

I, {first_name}, or the parents and/or legal guardian(s) of the minor participant named below, have read this Physician Verification, Authorization for Medical Treatment, Photography & Video, Promotional Release, and Termination of Participation, and I fully understand its terms. I understand that this agreement is incorporated by this reference as a part of my application form for participation in the T Elite Martial Arts, LLC. I acknowledge that I am signing this agreement freely and voluntarily and intend by my signature to make a complete and unconditional release of all liability to the greatest extent permitted by the laws of the State of Illinois. If any portion of this agreement is held invalid, I agree that the balance of it shall nevertheless continue in full force and effect.

{contact_name},

Below is a copy of the parent handbook for the after-school program.

In lieu of printing and signing the back page, your signature to this will constitute understanding and adherence to the after-school center policies.

Permission & Liability Waiver for Walking Trips
I, {Contact_Name}, the undersigned parent or legal guardian of {first_name}, give permission for my child to participate in supervised walking trips during the summer camp session at T Elite Martial Arts.

These may include walking to:

• Viking Park (4374 Old Grand Ave, Gurnee, IL) — approximately a 2-minute walk via O’Plaine Road.

• Viking Park West (920 Kilbourne Rd, Gurnee, IL) — approximately an 11-minute walk via Kilbourne Road.

I understand that staff will supervise all walks, and every reasonable effort will be made to ensure my child’s safety. I acknowledge that walking on public sidewalks and crossing streets carries inherent risks, and I assume full responsibility for my child’s participation.

By signing below, I waive and release T Elite Martial Arts, its staff, and affiliates from any and

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Transportation Permission & Liability Waiver
I, {Contact_Name}, the undersigned parent or legal guardian of {first_name}, give permission for my child to be transported by a commercial bus or van, driven by a licensed and insured driver, for field trips organized by T Elite Martial Arts Summer Camp.

I understand that:

• Transportation will be provided to and from various destinations.

• I will receive separate permission slips for each specific field trips.

I acknowledge that travel involves certain inherent risks. I hereby release T Elite Martial Arts, its staff, volunteers, and third-party transportation providers from any liability arising from injury, accident, or incident during transit.

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Aquatic Center Permission & Swim Responsibility Acknowledgment
I, {Contact_Name}, the undersigned parent or legal guardian of {first_name}, to attend the Waukegan Park District Aquatic Center and/or Waukegan Park District Splash Park (Waukegan, IL) as part of a field trip with T Elite Martial Arts Summer Camp.

Locations Covered:

• Corrine Rose Water Park – 412 S Lewis Ave, Waukegan, IL (outdoor water playground)
• Waukegan Park District Field House Pool – 800 Baldwin Ave, Waukegan, IL (indoor water park)

I understand:

• Lifeguards will be on duty and camp staff will provide supervision.

• It is my responsibility to notify T Elite Martial Arts in writing if my child cannot swim or requires a flotation device.

I release T Elite Martial Arts, its staff, volunteers, and the Waukegan Park District from any liability for injury or loss during participation in water-based activities.

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Bowling Activity Permission & Liability Waiver
I, {Contact_Name}, the undersigned parent or legal guardian of {first_name}, to participate in a summer camp field trip to Round 1 Bowling & Amusement at Gurnee Mills.

I acknowledge that while staff supervision will be provided, participation in bowling carries a risk of minor injuries, including slips, falls, or impact from equipment.

I waive any and all claims against T Elite Martial Arts and its representatives for injuries or damages resulting from this activity.

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Trampoline Park Participation & Liability Waiver
I, {Contact_Name}, the undersigned parent or legal guardian of {first_name}, to participate in a field trip to Launch Trampoline Park (Gurnee, IL) as part of T Elite Martial Arts Summer Camp.

I understand:

• This activity involves jumping, climbing, and other high-movement exercises.

• Participants are required to follow all posted safety rules and staff instructions.

I acknowledge that trampoline-related activities carry a risk of serious injury. I agree to hold harmless and release T Elite Martial Arts, Launch Trampoline Park, and all associated staff from liability for any injury or loss.

I understand that I may also need to complete Launch’s own online waiver for participation.

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