Grand River Karate Sign Up - New Participant
Please fill out and submit the following form, one for each participant. Once the form is processed you will receive an email detailing the price and confirmation of registration. Payment can be made on the first day of class in cash or cheque addressed to Grand River Karate.
Participant's Last Name *
Participant's First Name *
Address, City and Postal Code *
Phone Number (Home, Work, Cell) *
Date of Birth (Please Bring Proof of Age to The First Class; ie. Birth Certificate) *
MM
/
DD
/
YYYY
Emergency Contact Info (Name, Relation, Phone) *
OHIP Number *
Please List Any Relevant Medical Conditions You Wish Us To Be Aware Of
Please Check The Appropriate Level and If You Wish To Buy a Gi *
Required
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy