Capoeira Valente - Personal Information Form
Please make sure you have read and agreed to the terms and conditions of Capoeira Valente before filling out this form.
Please click here for terms and conditions: https://goo.gl/HDq60P: *
Student name and surname *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Parent/Gardian Full name
Your answer
Telephone number *
Your answer
Email address *
Your answer
How did you hear about us? *
Emergency contact name *
Your answer
Emergency contact number *
Your answer
Medical conditions, injuries or any other informations we should be aware of?
Your answer
Contract type *
Contract duration *
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