PACIFIC MARTIAL ARTS
(aka PMA, Pacific Martial Arts Federation USA, Inc.)
“We Teach Attitudes First!”
Note that only parents or legal guardians may sign for a minor. Please fill out all highlighted fields. INFORMATION IS KEPT PRIVATE. You can type in boxes and submit on line, or you may copy out the form and submit in person.
I, as a parent signing for my son(s) or daughter(s), or I as an adult participant signing for myself,
(Names printed of participants)
agree for my child/children (or myself) to participate
in a trial karate class, series of classes, birthday party, camp, or other event of the Pacific
Martial Arts (PMA). I affirm that my child (or I) is (am) in good physical condition &
health, and further agree that I enter into this course of instruction freely & voluntarily. I
understand that said instruction involves physical contact & that there is a possibility of
physical injury associated with said instruction. Such injury can include but not limited to bruises, lacerations, bone injury, neck and head
injury, back injury, ankle sprains, bleeding, etc. The instructors will exhort you to do things. I assume the risk of any such physical
injury and agree that no action may be taken on account of any said injury against PMA,
and the PMA assignees, and the PMA officers, and its instructors and employees, except
in the event of gross negligence on the part of said school.
I hereby agree to indemnify and save harmless PMAF, Jerry Devine and his appointed instructors and volunteers against any and all liability, loss damages, costs, or expenses which they may incur or be required to pay as a result of my (or my son's or my daughter's) participation in the Pacific Martial Arts' activities. I further agree not to make claim against any other person or corporation which mighty in turn make a claim against them.
If submitting on line, you agree that this electronic submission will represent your authority as if you are signing this the and the form is to be submitted from your personal email.
(Information is kept private!)
Parent Signature: (not required if sending to us online)
Parent Name printed:
Emergency phone
Class or event date
Location Del Mar Old Town Other
E-mail:
Minor's birth-date (m/d/y)
Address:
City and zip:
You may use this form .... type in the boxes and hit submit one time. If printing the form out on hard copy, please fill out and bring to the dojo or mail it in to
PMA
1010 University Ave. #264
San Diego CA 92103
Questions? Call 619-752-7515 or 619-299-8361 In case you have problems submitting, please just copy and paste this information into your regular email and send to pma@pmakarate.com. Thank you.
PMA Details and directions for driving.
PMA welcomes you to our special events. We may occasionally keep you informed of upcoming events that may interest you. We will not divulge your personal data to advertisers.
Please copy out this form or email it directly to us at pma@pmakarate.com. You can mail it to PMAat 1010 University Ave. #264 San Diego CA 92103.
Please look around web site pmakarate.com and feel free to go to our alternate website at pmakaratenation.com for a good look at the Pacific Martial Arts activities. You can reach us by phone at either 619-299-8361 or 619-752-7515. Thank you.
*Driving Directions to PMA Old Town:
2266 San Diego Ave. (92110) for google and mapquest
From the north... (Freeway)
Take I-5 south and just after passing the I-8 interchange Take the first exit called Old Town Ave. exit
Cross back over the highway on the overpass.
You will pass between the two gas stations, one long block to the light. Turn right onto San Diego Avenue at the light. 2266 is the second building on the left. It is a large light beige and brown building. Enter the second driveway. (Narrow driveway- over-sized vehicles, please park on the street.)
From the south... If traveling from the south, take I-5 north and exit at Old Town exit. Turn right between the gas stations, continue one long block to the light at San Diego Avenue. Turn right and our building is on your left at 2266 San Diego Ave. Use the right hand driveway. (Narrow driveway- over-sized vehicles, please park on the street.) If coming via I-8, 163 or 805, get onto I-8 west and exit onto I-5 south. Follow directions above. *Driving Directions to PMA Del Mar (Torrey Hills, Carmel Valley, Sorrento Valley dojo) 11855 Sorrento Valley Rd 92121 Coming from the south on I-5 or I805, take the 56 bypass, and the first exist is Carmel Mountain Rd. Take it, stop at the traffic light. Turn left downhill under the highway. One long block and the street ends at Sorrento Valley Rd. Turn right, the building is immediately on your right. Drive half way and we are in suite G, bottom floor! Coming from the north on I-5, exit 33 (to the 56 bypass) is the one to take and lets you off at the Carmel Mountain Rd. exit. Turn right at the light onto Carmel Mountain Rd and drive one long block to end or road. Turn right onto Sorrento Valley Rd. It is a large office type building immediately on your right. Drive half way and we are in suite G, bottom floor! The Old Town facility is 6,000 square feet with parking in back. Student will enjoy the large open areas, safe tumbling floors, wave master hitting bags and more. You can visit nearby tourist center of Old Town. At Del Mar studio, a safe environment with Olympic Swain matted floors and mirrors. There is parking both in front and in back. It is really easy to reach this studio from the major highways.