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 *
Your answer
Participant's First Name *
Your answer
Address, City and Postal Code *
Your answer
Phone Number (Home, Work, Cell) *
Your answer
Date of Birth (Please Bring Proof of Age to The First Class; ie. Birth Certificate) *
MM
/
DD
/
YYYY
Emergency Contact Info (Name, Relation, Phone) *
Your answer
OHIP Number *
Your answer
Please List Any Relevant Medical Conditions You Wish Us To Be Aware Of
Your answer
Please Check The Appropriate Level and If You Wish To Buy a Gi *
Required
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