Maine Traditional Karate: Registration
Student Full Name
Student Birth Date
Student Class Group
Select the best class group based on age
ORRINGTON: Adult (13+ yrs of age, MON/WED 6:45-8:00PM & FRI 6:30-7:45PM)
ORRINGTON: Youth (8+ yrs of age, MON/WED 5:30-6:30PM & FRI 6:30-7:45PM)
ORRINGTON: FRIDAY Little Samurai (4-7 yrs of age, 5:30-6:15PM)
ORRINGTON: THURSDAY Little Samurai (4-7 yrs of age, 6:00-6:45PM)
ORRINGTON: Rec Program (4-7 yrs of age)
CORINNA: Combined Class (All ages, THURS 6:00-7:15PM)
Please write out as follows: Mailing Address, City, State, Zip
Sign Up For Location
Emergency Contact Name
Emergency Contact Phone Number
If there are any medical conditions that may impact your ability to participate in a physically active impact sport, please note them here. This is to help inform instructors in order to keep the student safe.
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