Kids Capoeira Summer Intensive Registration
Fort Worth Capoeira presents a one-week of half-day classes of Capoeira and Brazilian Culture for kids aged 5-14 years. Single days are also available. Upon reciept of this completed form, payment information and waivers will be emailed to you. Registration will be complete once a signature and payment are submitted.

Each day will feature a variety of activities, including Percussion, Portuguese, Acrobatics, Folkloric Dance, Capoeira Regional, and Instrument-Building. Light snacks will be provided. The facilities include two air-conditioned activity rooms, and a large lawn area for outdoor play.

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Email *
Session(s) *
Indicate individual days, if applicable
Participant's Name (First and Last Name) *
Preferred Name
Age of child *
Parent/Guardian's Name *
Best Contact Phone Number *
Emergency Contact Name *
 Emergency Contact Phone Number *
Emergency Contact Relationship to Student *
Name of other authorized person to pick-up student (other than the parent/guardian) *
Other authorized person to pick-up student phone number *
Any health information (physical, psychological or otherwise) we should know about that could impact your child’s ability to participate? *
Food or other Allergies? *
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