Davidsonville Elementary PTO Enrichment Program

Welcome to the DES PTO Afterschool enrichment program sponsored by East Coast Martial Arts. To enroll your son or daughter, please fill out this form below. Please send a check with your child to school for $40.00 made out to the DES Elementary PTO. Please be sure to fill out the entire form so we know who is authorized.

Select or enter value
Caret IconCaret symbol

Who is picking up your Child / Children

If your child is in the SACC program afterschool, please check the box. If they are not and someone will be picking them up, please complete Authorized Pick up Box. Everyone must be on the Authorized Pick Up List. Parents too.

Please write down the names of anyone you might have pick up your child or children. Please advise them that they will need their driver license. Parents will also need their drivers license.

East Coast Martial Arts Permission and Liability Waiver

By acknowledging below and entering you name and date, the student (parent or legal guardian) recognizes the risk involved and agrees to the following terms and conditions required by East Coast Martial Arts in conjunction with participating in our classes/programs. The undersigned student, and or parent/guardian, releases East Coast Martial Arts, its officers, employees, and instructors from all liability for any and all damages and injuries suffered or sustained while at the elementary school or on East Coast Martial Arts School premises and under the instruction, supervision or control of East Coast Martial Arts, or its employees. The student, participant, or legal guardian, therefore, hereby agrees to individually provide for the possible future medical expenses which may be incurred as a result of any injury sustained while participating in any class, during training, or performing for East Coast Martial Arts. This form also acts as a release for East Coast Martial Arts to be able to use any pictures, videos, etc., for use as promotional tools or in any other use East Coast Martial Arts deems necessary. ASSUMPTIONS OF RESPONSIBILITIES NO RISK Martial Arts are a potentially dangerous activity. Bumps, bruises, scrapes, and soreness, are common place and most students will encounter this sort of minor injury from time to time in their training. More serious injuries are possible, including sprains, strains, twists, cramps, and injuries of similar magnitude, and students can expect to encounter these injuries frequently. The possibility of more serious injury exist, including fractured bones, broken bones, torn ligaments, though not all students encounter such serious injuries. There remains, despite safety precautions, the remote possibility of crippling death, though this is certainly not expected in this martial arts class or any workshop and training the ECMA provides. I understand the above statement of risk, and I understand the rights and responsibilities for my own safety (or the safety of my child), understanding and accepting the risk involved with martial arts training. Even if the instructor has informed me that no serious injury has ever happened in this school or with any of the instructors, I understand that this does not mean that there is no possibility of harm. By assuming this risk, I completely absolve all instructors, staff, guests, students, landlord, management companies, and any and all other parties of liability for my harm, unless intentionally caused in criminalconduct. I understand that the instructors, senior instructors, or others may have some skill in first aid, CPR, and at their discretion, I authorize them to use those skills and techniques to assist in any circumstance in which they judge their skills would be necessary or helpful. This acknowledgement of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily as to its content and intent, I hereby give my permission to trained medical professionals to administer emergency medical treatment to myself or child, should sickness or accident occur in my absences or in the event I cannot give permission.