Karate/Fitness Registration
Class starts Wednesday, February 6th for eight weeks from 6:30 - 7:30 PM. Payment can be made online (see below) or in person on the first night. Please arrive between 6:00 and 6:15 PM to complete your registration; a Release of Liability Form will need to be completed before class begins.
Adult Last Name *
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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
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Participant 4 Name
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Participant 4 Age
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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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