White Belt Camp Registration Form
White Belt Camp: July 30th - September 6th; Tuesday 5:00 - 6:00 & Thursday 5:00 - 6:30pm

Pricing: $65 (includes camp T-shirt, white belt and testing fee)
Event Address: 1108 5th Ave, Grinnell, IA 50112
Contact us at (319)430-0226; forresttkd@gmail.com OR gibsontkd411@gmail.com
Website: www.grinnelltkd.org

Email address *
Parent/Guardian Contact Name(s) *
Your answer
Student Name *
Your answer
Student Birthdate *
MM
/
DD
/
YYYY
Grade (School Yr 2019-2020) *
Your answer
Student's T-shirt size *
Required
Mailing Address *
Your answer
Email *
Your answer
Phone *
Your answer
Liability Waiver (Check for understanding) *
Required
Payment Info *
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