Sign Up INTRODUCTORY CLASS SIGN UP Date: Parent/Guardian Name: Student Name: Age: Date of Birth: Email: Work: Home: Cell: Will you be living in the area at least one year? YesNo Can you afford to budget between $149- $229 for classes each month? YesNo Do you have a place to practice what you learn in class? YesNo Can you commit to training in karate class two times per week for the next 6-12 months? YesNo Signature of Applicant Signature of Parent or Guardian Date What specifically would you like your child to accomplish in our martial arts program? School: Grade: Teacher: Honor Student Average Student Need a little help Other activities Medical Concerns How did you hear about us? Website Website Sign Other Referral Referrer's Name Please check the most important benefits you would like to see from your child’s training at the school: Better Grades Better Mental Attitude Self Defense Respect for Others Leadership Skills Improved Grades Self Confidence Weight Control Stress Release Physical Conditioning More Energy Temper Control Self Discipline Respect for Self
