Women's Self Defense Class Registration
Please fill out the form below to reserve your spot in an upcoming workshop:
Your Name:
Your answer
Your Email Address:
Your answer
If this class is for your daughter, what is her age?
Your answer
Were you referred by a UMA student? If so, who?
Your answer
Has a friend of yours requested a reservation for the workshop? If so, who?
Your answer
What times work best for your schedule?
Required
Preferred method to pay the refundable $10 reservation fee?
Note:
For those who choose to use PayPal, please note I will need to subtract PayPal's service fee (less than $1) from the reservation amount upon refund.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms