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Martial Arts Sign-up Form and Waiver

Interested in our services? Get in touch with us by filling out the form below and we'll get back to you as soon as possible! All martial arts students get a private lesson once a week. Talk with the instructor to set up a date and time. Also read the Waiver Form Listed Below! By filling out this form you are agreeing and acknowledge and accept all of the contents of the Waiver Listed Below. Dated 4/10/2010

Name*

Please tell us a little about yourself and what you would like to achieve:

Phone

Email Address

Please select a program:*

Which program works for you? Required

How would you like to be contacted?*

Where would you like us to teach?*

Will others be attending with you?*

Are their any medical concerns the instructors need to be aware of?*

What is your age range?*

How would you like to pay for the services provided?*

I Acknowledge, Agree, and Understand all the contents of the Waiver*

Thanks for submitting!

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