AMAA Learning Center Enrollment 2026–27

AMAA Learning Center · 2026–2027 School Year
15 McCoy Place, Simi Valley, CA 93065 · (805) 587-9999

Student: {name}   Date of birth: {dob}
Home address: {address}

School and schedule

School:

Grade this school year:

School dismissal times, Mon–Fri (for example, Mon/Tue/Thu/Fri 2:50, Wed 1:30):

Days attending the Learning Center (pick 3, 4 or 5 to match your plan):

Days attending Taekwondo class:

Parent / guardian 1

Name:   Relationship:

Employer:   Work phone:   Alt phone / cell:

Address, if different from the student’s:

Parent / guardian 2 (if any)

Name:   Relationship:   Contact phone:

Employer:   Work phone:

Address, if different from the student’s:

Household

Marital status (married, separated, divorced, widowed, single):

Child lives mainly with:

Main contact email:

Emergency contacts / authorized pickup

The emergency contact should be someone who can pick up your child within minutes. In an emergency, AMAA Learning Center will make every effort to contact parents first. If the parents cannot be reached, the people listed below are authorized to pick up my child. Please list names as they appear on official identification.

Contact 1 (from your sign-up): {contact_name} · {contact_relation} · {contact_phone}

Contact 2 – name, relationship, main and alt number:

Contact 3 – name, relationship, main and alt number:

Contact 4 – name, relationship, main and alt number:

Health

Medical concerns or allergies (write “none” if none):

Medications being taken (write “none” if none):

Physical impairments:

Additional siblings

Enrolling more than one child? Parent/guardian info, emergency contacts, authorized pickup, insurance and pay plan from this packet apply to every sibling. A 5% discount applies to the second student enrolled.

Sibling 2 – name, date of birth, grade, school if different, dismissal times, Learning Center days, Taekwondo days, allergies/medications, photo release yes/no:

Sibling 3 – same details:

AMAA photo release authorization

Yes, I give permission for my student to have his/her photo appear in printed media, the AMAA website and the Learning Center Facebook. (Leave unchecked if you do not want photos used.)

Signed by on {sign_date}.

AMAA Learning Center · Policies & Procedures · 2026–2027

Please read each policy and add your initials.

All fees (registration and first month’s tuition) must be paid in full prior to the child’s starting date unless other arrangements have been made with the Business Office. All monthly payments are due on the first of each month. Payments must reach the school by the 5th of each month; a $25.00 fee will be added in all cases of late payments.

All tuition fees listed are for the school year months (Fall 2026 – Spring 2027). Lunch is not included. If there is a second student enrolled in AMAA Learning Center, a 5% discount will be allowed for the second student.

I/We understand that a $25.00 fee will be charged for any individual check that does not clear the bank for any reason. A cashier’s check, money order, or cash must be submitted to the Business Office within five (5) days to cover such an unpaid check.

The enrollment agreement is a month-to-month contract. We ask parents to provide at least one month’s written notice if their child will not be continuing with our program. Clearly list the last day of planned attendance so that we can instruct the business office. Tuition is paid in advance; therefore, the 30-day countdown begins on the 1st day of the following month.

AMAA Learning Center reserves the right to dismiss or expel the student at its own discretion. In the event of said dismissal, all tuition charges will be prorated to the last day of attendance. I/We understand there are no other tuition or registration fee refunds.

Any child not picked up by 6:00 p.m. will be charged $1.00 per minute after 6:00 p.m., with a minimum charge of $5.00, and will be picked up at the Martial Arts Studio.

Vacation is accrued at the ratio of 1 week per 3 months attended. For vacations, three weeks of credit is allowed per school calendar year. A vacation week is based on the number of days your child attends per week (i.e., 3-day schedule = 9 days of vacation credit). Vacation credits need to be taken by the week, not by the day. The vacation request needs to be submitted before the vacation. NO REFUNDS WILL BE ALLOWED FOR ABSENCE.

If your child participates in after-school activities that require them to be picked up at a special time away from the regular route, the parent is responsible for notifying the front desk as well as arranging alternate transportation for the day, or pay an extra fee of $25.00 per pick-up if it is going to require a weekly pick-up. Failure to give notice before 11:00 am will result in the $25.00 No Call Out Fee.

I hereby acknowledge that I am aware that AMAA is not a daycare but an enrichment program.

During the school year, I understand that we can add morning sessions on days when school is closed and the Learning Center is open. There is an additional cost of $25.00 per morning, with drop-off between 7 a.m. and 12:00 p.m. Registration must be completed in advance. Any registration on the day of service will incur an adjusted fee of $10.00.

During the school year, parents must notify the studio of any absences before 11:00 am. If your child is not at the pick-up point, our driver will contact the main office and the studio to locate the student. Non-calls delay the route and cause us to be late picking up other students. I understand that there is a $25.00 penalty for not calling in before 11:00 am for my child’s absence.

Monthly Plan: month-to-month; cancel with 30 days’ written notice as stated above. 2-Installment Plan: to cancel before the contract is paid in full, you must give 30 days’ written notice and forfeit 30% of the remaining contract balance.

Credit card payments: Visa and Mastercard only (no American Express or Discover). A 2.95% processing fee is added to all credit card charges. No fee for debit cards, checks, or cash.

I have read and fully understand and accept the terms as stated above and hereby enroll my child(ren). Student: {name}   Siblings also enrolled (if any): . Signatures are required from each custodial parent.

Second custodial parent (if applicable), full name:

Signed by on {sign_date}.

American Martial Arts Academy & Learning Center · Consent & Release Form – Minor · 2026–2027

Participant: {name}   Date of birth: {dob}
Name of activity: All Learning Center & AMAA approved activities   Dates: 2026–2027 School Year
Location of activities: All locations and activities

I, , the parent/guardian of {name}, have been informed of the above activities sponsored by American Martial Arts Academy & Learning Center. I do hereby give consent for my minor child to participate in these activities. I am voluntarily allowing my child to participate in these activities, including transportation to and from them, with knowledge of the associated dangers and risks. I hereby agree to accept any and all risks of injury and/or death arising out of participation and transportation.

I understand that all reasonable safety precautions will be taken by AMAA staff, and that the possibility of an unforeseen hazard exists. In such a case, I, along with all family members and/or representatives of the minor child and myself, further agree not to hold AMAA, its leaders, employees, and volunteer staff, liable for any and all damages, losses, diseases, injuries, and death incurred by the minor listed above.

I HAVE CAREFULLY READ THIS RELEASE AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND A PROMISE NOT TO SUE OR MAKE A CLAIM, AND I SIGN THIS OF MY OWN FREE WILL.

I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT.

Additional people authorized to pick up my child

Authorized person 1 – full name, relationship, phone:

Authorized person 2 – full name, relationship, phone:

Authorized person 3 – full name, relationship, phone:

Executed at (city) , California on {sign_date}.

Parent/guardian signature:

American Martial Arts Academy & Learning Center · Consent to Treat – Minor · 2026–2027

Minor: {name}   Date of birth: {dob}
Address: {address}   Phone: {phone}

I hereby consent to any X-rays, anesthetics, medical, surgical, or dental diagnosis or treatment that may be deemed necessary for my minor child. In the event I cannot be reached in an emergency, I give permission to the activity leader(s) to make the decisions necessary for treatment. Should no activity leader be available, I give the attending physician permission to treat my child. I understand that the doctors, dentists, and other providers attending to my child will take all reasonable safety precautions during their care. Further, as parent or legal guardian, I hereby agree that I am financially responsible, either personally or through my health insurance plan, for any dental, medical, or hospital care or treatment that is given to my child. Any policy of American Martial Arts Academy will be used as secondary coverage.

I am the child’s (parent or legal guardian):

Medical insurance information

Insurance company:   Phone:

Policy number:   Group number:

Doctor’s name and phone:

Dentist’s name and phone:

Health history

Allergies (medicine, food, etc.):

Medications being taken:

Physical impairments:

Executed at (city) , California on {sign_date}.

Signature: