Karate/Fitness Registration
Class begins on Wednesday, April 10 for 6 weeks from 6:30-7:30PM. Please arrive at 6:15pm on the first night to complete your registration and a Release of Liability form. Payment can be made online (see below) or on the first night of class. We look forward to seeing you there!
Email address *
Adult Last Name *
Your answer
Adult First Name *
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Address *
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City *
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State *
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Zip *
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Phone number *
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Participant 1 Name *
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Participant 1 Age *
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Participant 2 Name
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Participant 2 Age
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Participant 3 Name
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Participant 3 Age
Your answer
Participant 4 Name
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Participant 4 Age
Your answer
Do any of the above participants have any disabilities, handicaps, hemophilia, heart condition, asthma, history of respiratory illness, or any other significant medical condition? *
If yes, please tell which participants and a brief description of the medical condition.
Your answer
$40 fee covers 1 person or the whole family!
You may pay online at knoxvineyard.org under the "give" tab (click Karate/Fitness in the drop down box) or you can pay by cash or check on the first night.
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