2024/2025 DYMA AFTER SCHOOL REGISTRATION

Click the Submit Button at the bottom to complete your application!
ONCE WE HAVE SUCCESSFULLY RECEIVED YOUR APPLICATION, WE WILL CONTACT YOU TO DISCUSS PAYMENTS, SCHEDULING, & OTHER DETAILS.

PARENT/LEGAL GUARDIAN'S INFORMATION

STUDENT INFORMATION

What DYMA Location Are You From? *
Which DYMA Location Will You Attend? *

DETAILS

2024-2025 SCHEDULE/PRICING
DAYS PER WEEK *
For Two or Three Day Options: Choose Days
*NEW MEMBERS ONLY: Check "Registration and Uniform - New DYMA Member" *
BREAKDOWN FOR NEW MEMBERS:
- Registration Fee is $100
- Uniform Fee is $60 
- Weekly After School fee is determined by # of days (2, 3, or 5 days a week)
First week deposit is required and there are no refunds. 
Authorization *
This Program Includes: 
- Homework Assistance
- Taekwondo Classes
- Physical Exercise Class
- Arts, Crafts, STEM, and Fun Games
- K to Middle School
- Follow all State Regulation Guidelines
- Safe & Clean Environment
- Class size is limited
Terms and Waiver:
I agree to waive any and all claims against Dragon DYMA Martial Arts and all people connected with it. This contract serves as permission to have my child(ren) transported to any health care facility and for him/her to receive any and all emergency health care should the situation arise. 

As we are all aware, children are prone to mishaps. Although Dragon DYMA Martial Arts makes every effort to have adequate supervision, occasionally accidents can happen.  In the instance that an emergency arises, we would need your specific permission to transport and have your child treated by a professional care giver/physician, etc. DYMA will not be responsible for any liabilities issues occurred.

For the safety and well being of our students and staff, Dragon DYMA Martial Arts reserves the right to remove any child from our program. 

I agree that any picture taken of my child(ren) in connection with the After School Program can be used by Dragon Yong-In Martial Arts for publicity or promotion without compensation at this or any other time.

By signing below, I verify that all the above information is correct and that I agree to the terms stated above.

Signature of Applicant/Parent/Guardian *
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PURCELLVILLE

310 N 21st St, Purcellville, VA 20132
571-271-8039  /540- 338- 6660

BRAMBLETON/DULLES/MOOREFIELD

22895 Brambleton Plaza #110, Brambleton, VA 20148
571-271-8039  / 703 - 542 - 7326