You may submit an enrollment application using one of the methods below:

Option #1 – Physical Application

Click Here to download a physical copy of our enrollment application. Once completed, you may submit it in-person at our location.

Option #2 – Online Application

    I agree to use an electronic signature for the purpose of submitting this application.

    Full Name of Parent/Guardian submitting this application:

    Initials of Parent/Guardian submitting this application:

    Full Name of Mother:

    Full Name of Father:

    Signature of Parent/Guardian to be used in this application
    (please sign electronically below)

    Today's Date :

    Child's Full Name:

    POLICIES

    1. All payments are due weekly on Monday. Payments not received by the due date
    will have a $10.00 late fee assessed

    2. If your child is absent for more than 1 week without notification your spot will be
    filled & you may be placed on our waiting list for the next available spot.

    3. NO REFUNDS

    4. You are purchasing a spot in our program, so you must pay each week to keep that
    spot for your child if you attend or not. We allow one week off for summer vacation
    without paying.

    5. We follow Pasco County school’s Hurricane closure policy.

    Kids Kicking High Sports Academy firmly believes in the abilities of our operations manager. Mark Phillips is always available for consultation. However, it is highly recommended that an appointment time be scheduled to avoid waiting during peak hours. We thank our existing members for their continued loyalty. We constantly strive for perfection to accommodate your needs, but we must have guidelines to keep the After School running efficiently. Please help us to better serve you.
    Welcome aboard new members!

    OPEN ACCESS

    Kids Kicking High Sports Academy is a Transported before and after school sports program, a constructive alternative to daycare, extended-day and baby-sitting for children after school. This Transported After School Martial Arts (TASMA) program was created and has been perfected by Kyoshi Jim King since 1991. There is no expectation of childcare at our school. We are an open access, free to come and go facility. Children stay here at the direction of their parents and because they want to learn the sports that are taught here.

    CONTRACT FOR STUDENT TRANSPORTATION

    School Name :

    PARENT RESPONSIBILITY CHECKLIST

    Pickup Contacts

    1) Name :
    Phone:

    2) Name :
    Phone:

    3) Name :
    Phone:

    4) Name :
    Phone:

    5) Name :
    Phone:

    6) Name :
    Phone:

    Additional Information and Acknowledgements

    Student's Date of Birth:

    Student's Home Address
    Street Address:
    City:
    State:
    ZIP:

    Parent/Guardian(s) Phone Numbers

    Home:

    Mother's Phone Number(s)
    Cell:
    Business:

    Father's Phone Number(s)
    Cell:
    Business:

    In case of emergency contact (other than yourself)
    Name:
    Phone:

    Allergies:

    Refer to KKHSA new member packet for full list of policies & additional fees.

    Additional Policies

    1.All payments are paid weekly on Monday. Payments as of Tuesday morning will have a $10 late fee
    2.You must pay your fee if you attend or not. You are purchasing a spot that is being held for you.
    3.I UNDERSTAND THAT KKHSA /S A BEFORE AND AFTER SCHOOL SPORTS ACADEMY AND NOT A DAYCARE IN AS SUCH, THEIR STOCK-IN-TRADE IS NOT SUPERVISION AND CARE. THE INTENT OF Kids Kicking High SPORTS ACADEMY IS TO TEACH VARIOUS SPORTS AND PHYSICAL AND PHILOSOPHICAL CHARACTER BUILDING SKILLS. I UNDERSTAND THAT Kids Kicking High SPORTS ACADEMY IS AN OPEN ACCESS FACILITY IN AS SUCH; MY CHILD IS FREE TO COME AND GO. ADDITIONALLY, IF MY CHILD STAYS AT THE Kids Kicking High SPORTS ACADEMY FACILITY IT IS BECAUSE OF MY DIRECTION AND NOT THE SCHOOL'S. THERE ARE NO EXPECTATIONS OF CHILD CARE.
    4.CONFIDENTIALITY CLAUSE: Kids Kicking High Sports Academy will not release this personal and private information to any third party for purposes of sales, advertising or for any other reason.
    5.WAIVER & RELEASE: Buyer(s) understands that Student(s) is engaging in physical activity/exercise, along with the use of Kids Kicking High Sports Academy facility, equipment, training and
    instruction, which can be dangerous & could cause injury. Therefore Buyer(s), assumes all risk of injuries to said individual(s). Buyer/Student(s) hereby waives and releases any
    claim or right to sue the school, employees or agents for injury. Buyer(s) has carefully read this waiver & release and fully understand that it releases Kids Kicking High Sports Academy of all
    liabilities for any injury that may occur. It is always advisable to consult your physician before undertaking any physical activity/exercise program, particularly sport activities.
    6.LOSS/DAMAGE/THEFT: Kids Kicking High Sports Academy does not assume any responsibility for the loss, damage or theft of any property belonging to the Buyer(s)/Student(s) and agrees that Kids Kicking High Sports Academy and its personnel are not responsible or liable for any such property in the event of loss, damage, or theft on or about the facility.

    Release for Emergency Care

    Physician Name:
    Physician Phone Number:

    Allergies:

    Medications your child is taking:

    Insurance Company covering your child:

    Insurance Policy Number:

    Insurance Expiration Date:

    Release and Waiver of Liability and Indemnity Agreement

    Please click here to read the Release and Waiver of Liability and Indemnity Agreement.