FREE Self-Defense Class with Janet Gee: Pre-Enrollment Form
Spring 2017

WHEN: Saturdays 2-3:50PM; April 1, 2017 - May 20, 2017
WHERE: Mission Campus 109 (1125 Valencia Street, San Francisco)
ALL AGES: 14+ SFUSD high school students welcome with parent/guardian permission

While completing this pre-enrollment form is not required in order to take the course, we strongly encourage you to sign up. This allows for us to have a more accurate prediction of the class size and to anticipate any class needs. We ask for your phone number so that we can send you a reminder prior to class starting.

STUDENT LEARNING OUTCOMES
Upon completion of this course a student will be able to:

A. Demonstrate centering and grounding techniques.
B. Identify areas of vulnerability on assailant's body and areas of strength on own body.
C. Demonstrate strong, assertive verbal skills.
D. Demonstrate defensive physical skills.
E. Identify violence prevention strategies in public settings.
F. Identify violence prevention strategies in personal relationships.
G. Summarize psychological and physical self-defense skills and primary self-defense
principles.

Last Name, First Name
ex: Arruda, Elisabeth
Your answer
Email address
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Phone Number
ex: 415-XXX-XXXX
Your answer
How did you hear about the class?
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