Karate Birthday Party Agreement

This Birthday Party Agreement (“Agreement”) dated between Kempo Karate of Manorville,

Inc. DBA Kempo Karate and Fitness (“Kempo”) located at 585 Montauk Highway, Eastport, NY 11941 and

Parent Name __________________________________ (“Party Giver”)

Address ________________________________

City _________________________ State ____ Zip Code ________

Phone # __________________________ Email Address ________________________________

Birthday Boy/Girl _____________________________ Age ______

Date of Party ___________________ Time ___________

Description of Services: Kempo will conduct a 1 1/2 hour party including an introductory Karate lesson and games

including Dodge Ball, Capture the Flag, Bag Races, Tag and Block and other fun plus Pizza, Drinks, Napkins and Paper

Plates, Tables and Chairs at the location, date and time listed above. A cake or decorative items, if desired, must be

supplied by the Party Giver.

Payment for Services: Party Giver will pay a minimum fee of $250 for up to 12 children (party restricted to ages 6 to

12); any additional attendees, up to a total count of 20, (unless a different amount is approved at time of reservation)

for $14 each.

$100 Deposit is due with your reservation to reserve your date and time with a final count required 5 days before

the party. Balance due the day of the party.

Party Giver’s Obligation: Party Giver must be on premises at all times. Party Giver is responsible for the children’s

special needs as required. The Party Giver will distribute a release form to all participants and have completed,

signed copies given to Kempo prior to the beginning of the party for each attendee. Release forms to be supplied

by Kempo.

Release & Waiver of Liability: The Party Giver and signer of the agreement acknowledge that the studio, “Kempo” or

any affiliate, its instructors and employees are not responsible for any injury to participants and by this agreement,

the undersigned assumes all risks inherent and incidental to this type of activity as a condition of participation. The

signer acknowledges that there are no medical ailments that would prevent any attendees from participating in the

lessons, games and activities.

Please Print Name _________________________________

Parent Signature _______________________________ Date ________________