Carterville FBC Karate is a fun family activity designed to teach self defense, coordination, respect, con-

fidence, sportsmanship and Christian character. This is a ministry of Carterville First Baptist Church

which means it is Christian first and Karate second. Our goal is to build strong faith driven people of

God. Mixed Martial Arts taught at Carterville FBC Karate. Students will learn how to defend them-

selves, how to deal with bullies and how to walk away from fights. Students will learn offensive skills,

defensive skills and grappling skills so they are well protected in all dangerous situations. Students

have a set curriculum for belt promotion. For offense our main Martial Art is Muay Thai Kickboxing. For

defense our main Martial Art is Kenpo Karate. For grappling our main martial art is Brazilian Jiu-jitsu.

Students will also learn skills from Filipino Martial Arts, Shaolin Chin Na Kungfu, Sambo, Wing Chun,

Aikido, Catch Wrestling, Kyokushin Karate, Kajukenbo, Judo, Jeet Kune Do, and Krav Maga

Schedule

First Class is Free!

Monday 6:00pm-7:00pm Group Class Ages 5-11

Tuesday 6:00pm-7:00pm Group Class Ages 12 and up

30 minute Private lessons are available throughout the week.

Cost

All group classes are $5 per week, per person

All Private lessons are $5 per lesson

Money can be paid directly to the Instructor before or after class.

Don’t let financial difficulties keep you from attending. Speak with the Pastor and

let us see how we can help

For beginners the only uniform requirement is the use of a cup.

Once the student earns their first stripe they should purchase a Gi and a white

belt.

Carterville FBC T-shirts can also be purchased and used as a uniform top.

Students should purchase bag gloves, boxing gloves, or MMA gloves as soon as

financially possible for heavy bag training.

Once students reach grey belt they should purchase an approved set of sparring

gear.

Rules

1. After trying a few classes we ask students to make a six month commitment to attend.

This will help build a never give up character.

2. Students should attend group class every week. Students will only progress if they are

consistent with their practice. This builds a persistent character

3. Private lesson need to be canceled two hours in advance.

4. Arrive 10 minutes early. This builds a dependable character.

5. Parents please keep conversations and distractions quiet so the students have a better op-

portunity to focus

6. No students are allowed the use of electronic devices during class time.

7. Any Student found to be bullying others will be dismissed.

8. Students in school must maintain a “C” average

9. Instructor may discipline students

10. Practice good personal hygiene. Wash hands, keep feet clean, use deodorant and tooth-

paste.

11. No jewelry during class

12. Bare feet and martial art shoes are only allowed on the mats.

13. Bow before entering and when leaving the training area.

14. Practice control with gentleness so no one is injured.

15. Unnecessary roughness, crude language, or a bad temper is forbidden.

16. Students must use manners and say, ”please, thank you, sir or ma’am.”

17. When responding to an instructor respond with sir or ma’am

18. No horse play or unnecessary talking during class.

19. Practice hard, be focused and serious

20. Have Fun!

Last Name _______________ First Name __________ Middle I. ___

Preferred Name/Nickname: __________________________________

Home Phone______________ Cell Phone ________________

Birthday ____________ (please include year)

Parent or Guardian _________________ Relationship: ___________

Parent or Guardian _________________ Relationship: ___________

Parent or Guardian Work Phone: _____________________________

Parent or Guardian E-mail: _________________________________

Home Address ____________________________________________

City ____________ State _____ Zip Code ____________

Emergency Contact Information:

Name:_____________________ Phone: ____________________

Hospital Preference:____________________ Phone:____________

Allergies: ________________________

Health or Special Needs Info: _____________________________________

I have read and understand the Rules and Information sheets and signed all releases. I confirm

the above information is correct and I am an authorized guardian or parent if the student is a

minor. I also agree to maintain a six month agreement to participate fully in classes. I agree

with all rules of Carterville FBC Karate.

Student Name: ______________________

Student or Parent/Guardian Signature:________________ Date: ________

Parent/Guardian Name: _______________________

Sign below if you give Carterville FBC Karate permission to use electronic and traditional media

of you or your child for promotional or educational purposes.

Signature: ___________________ Date: _______________

Release and Waiver of Liability and Indemnity Agreement

In consideration of being permitted to participate in any way in the Martial Arts Program indicated below and/or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the general public is prohibited), the parent(s) and/or legal guardian(s) of the minor partici-pant named below agree:

1. The parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating in the below martial arts activity or event, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such condition and refuse to participate. I understand and agree that, if at any time, I feel anything to be UNSAFE; I will immediately take all precautions to avoid the unsafe area and REFUSE TO PARTICIPATE further.

2. I/We fully understand and acknowledge that:

a. There are risks and dangers associated with participation in martial arts events and activities which could result in bodily injury partial and/or total disability, paralysis and death.

b. The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe.

c. These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of oth-ers, including, but not limited to, the Releasees named below.

d. There may be other risks not known to us or are not reasonably foreseeable at this time.

3. I/WE accept and assume such risks and responsibility for the losses and/or damages following such injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.

4. I/We HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the martial arts facility used by the participant, including it owners, manag-ers, promoters, lessees of premises used to conduct the martial arts event or program, premises and event inspectors, underwriters, consultants and others who give recommendations, directions or instructions to engage in risk evaluation or loss control activities regarding the martial arts facility or events held at such facility and each of them, their directors, officers, agents, employees, all for the purpose herein referred to as “Releasee”…From all liability to the undersigned, my/our personal representatives, assigns, executors, heirs and next to kin For any and all claims, demands, losses or damages and any claims or demands therefore on account of any injury, including but not limited to the death of the participant or damage to prop-erty, arising out of or relating to the events(s) caused alleged to be caused in whole or in part by the negligence of the releasee or otherwise.

5. I/We HEREBY acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLI-GENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.

6. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.

7. On behalf of the participant and individually, the undersigned partners(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release. If, despite the release, the participant makes a claim against any of the Releasees, the parents(s) and/or legal guardian(s) will reimburse the Releasee for any money which they have paid to the participant, or on his behalf , and hold them harmless.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WTHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Martial Arts School _____Carterville FBC Karate________________________________

Student/Participant Signature ____________________________________

Parent or Guardian Signature (if minor) ____________________________________

Printed Name of Participant _______________________________________________

Address of Participant ____________________________________________________

Received by _____________________________________________________________

Registrar Signature Printed Name Date

Technique

Defensive Hands

Jab

Cross

Technique

Wrap Around A & B (Left hand grab to right shoulder from 3 o’clock)

Basics

Greeting Horse Stance

Neutral Bow

Forward Bow

Technique from Guard

Trap and Roll - Standard

Punch Block

Headlock

Open Guard Pass

Reflex Development

All variations of Trap and Roll to Open Guard Pass

Basics

White Belt Stripe 1

Theory

Proper Breathing

Opposing Force

Theory

Circle

Lines

Cutting the circle in

Exercises

2 leg swings each leg

2 Push ups

5 Sit ups

Off

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Memory Verse-Genesis 1:1 (from any of the following translations: KJV, NKJV, NIV,

ESV,HCSB, NASB)

Ch

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Fruit of the Spirit Award- Friendly, Kind

Bible Study Award- Memory Verse

Good Character Award- Teachable, Well Behaved, Good Manners

Loyalty Award- Karate Attendance, Church Attendance, Awana Attendance