SENSEI MEIR’S KARATE
SPECIALIZING IN TRADITIONAL MARTIAL ARTS,
STRANGER SMARTS, & SCHOOLYARD SMARTS
WHO: BOYS AND GIRLS AGES 6-12 YRS OLD
WHEN: SUNDAY MORNINGS (SEE SCHEDULE)
WHERE: CONGREGATION ANSHEI SHALOM
COST: SEE ATTACHED AGREEMENT FOR DETAILS
SPACE IS LIMITED. PLEASE CALL HOWARD NENNER TO RESERVE A SPOT
516-710-1968
All students must have a signed waiver before starting the class. ___________________________________
Sensei Meir Breuer, OTR/L, a third degree black belt in Martial Arts has been for over 30 years a student of Professor Haim Sober, head of the Tora Dojo system of martial arts. In addition, Meir trains with Master Daniel Segarra, an expert in self-defense for children (“anti-bullying” and “Stranger-Smarts”). Meir has been teaching karate since 1988, as well as treating special children as an occupational therapist in the NYC school system since 2003.
SENSEI MEIR’S KARATE AND SELF DEFENSE, LLC
School year 2014-2015
Please note the following when enrolling your child at Sensei Meir’s Karate at Anshei Shalom:
PRICING PER SEMESTER:
For this semester, there will be eight scheduled classes. The price for the semester is $180.00. Checks are made out to Anshei Shalom. Checks must be submitted to the shul before your child starts the classes. A NEW UNIFORM IS INCLUDED.
WAIVER:
As per my liability insurance rules, all parents must fill out a waiver form by the first class.
Although the following information does not pertain to the first semester, the following information is mentioned here for the second semesters so that the parents are clear from the beginning of all the potential charges:
Ranks and Belts:
Solid color belts (official ranks in the Tora Dojo system), are typically awarded once during the 10 month school year. There will be a $50.00 charge for the rank (we cover the cost of the actual solid color belt). This fee goes directly to Haim Sober, founder of the Tora Dojo Karate Assn.
Other belts, for example striped belts that are not official ranks but motivators for the children, are $8.00. Rank/belts awards are strictly based on one’s quality of technique as well as outstanding attendance and proper behavior.
Protective Gear:
I will be asking that students purchase protective equipment for the head and arms for approximately $50.00 (Please note that I try to keep the price close to wholesale). In addition, I recommend a groin cup for the boys.
Karate Show:
Usually, Sensei Meir’s Karate has an annual show at the end of the school year. All the classes come together and perform for the family members at Yeshiva of South Shore’s gym. The cost of the show for the family is $10 for the first sibling, and $5 per additional sibling.
Please keep one copy of this agreement for your records and sign and return the second copy to me along with the signed waiver by the first karate session.
I appreciate your cooperation on these matters.
Sincerely,
Sensei Meir Breuer OTR/L
I have read and understand the above letter. I will comply with all the above.
Print Name: Signed: _________________ Date:___________
Please circle one of the following:
I DO / DO NOT give permission to Sensei Meir to take photos and submit to local newspapers.
WAIVER AND ACKNOWLEDGEMENT
I, Mr./Mrs._______________________, have enrolled my child (ren) __________in
the karate class taught by Meir Breuer at_______________. I understand and acknowledge that a karate class may involve activities that may potentially cause injury. It should be noted that great care will be taken to prevent any possible injuries. I further acknowledge that my son/daughter is covered by private medical insurance for both primary and catastrophic medical care. In the event of an accidental injury to my son/daughter, I agree that the private medical insurance will be used to cover any necessary medical care for any accident that might happen to my child(ren) during the time he/they is/are at the karate class. I also understand that a good faith attempt will be made to contact me in the most expeditious manner possible should any accident or injury occur. If it is impossible to communicate with me, I hereby authorize and give full permission to any physician in attendance or Emergency Medical Technician to render any treatment that such individual determines to be necessary or advisable for my best interests.
I further agree to waive any claims that my child or I may have against Meir Breuer, any assistant teacher, or *facility relating to said injury, unless such injury results from the negligence of the instructor.
I have read the above and agree and request permission for my child to participate in the Karate class.
If there are any pre-existing medical conditions that may prohibit full participation in the class, or if there are any physical limitations at all, a doctor’s note is mandatory. Please indicate as such below and submit with the doctor’s note, if necessary.
_______ I hereby represent that my child does not have any preexisting medical conditions that might make it inadvisable to participate in the Karate class.
______ My child does have physical limitations, and a doctor’s note is attached.
Parent’s Signature________________________ Date______________________
Classes may be held in various locations. This Waiver is meant to cover all facilities in which the child attends classes.
SUNDAY MORNING KARATE SCHEDULE –FALL 2014
NOVEMBER: 16TH 23rd, 30TH
DECEMBER: 7th 14TH 28TH
JANUARY: 4TH 11TH