"Knowing is not enough; we must apply.
Willing is not enough; we must do." — Bruce Lee

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IF UNDER 21 YEARS OF AGE — NAME OF PARENT OR LEGAL GUARDIAN

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IN CASE OF EMERGENCY, PLEASE CONTACT
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Please describe prior Martial Arts training, if any:

 

Please list any health problems or physical limitations:

 
What are your reasons for taking Martial Arts? (Please check all that apply)
Self Defense Self Confidence Self Discipline Lose Weight
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WAIVER OF LIABILITY

Due to the nature of this class, we ask that you read the statement below. Please check "I Agree" to indicate that you accept all terms.

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