Karate Enquiry Form
Sensei Elmarie van Zyl (Cell: 082 934 4670, Email:
elmarie@evzkarate.co.za
, Website:
www.evzkarate.co.za
)
* Required
Email address
*
Your email
Which dojo is in your area?
*
Germiston Karate Centre (26 Angus Str, Germiston South)
Helderfontein Karate Dojo (Reddam House School, Helderfontein, Midrand)
Kyalami Shotokan Karate (Equifox Park, 137 Crocus Road, Midrand)
Reddam House School, Waterfall (Midrand)
Samurai Karate Centre (46 Nicolas Smit Ave, Krugersdorp, 1739)
Not Sure
Your Name and Surname
*
Your answer
Name and Surname of person interested in doing karate
Your answer
Age of person interested in doing karate
*
Your answer
Has he/she done karate before?
*
Yes
No
If “Yes”, what was/is his/her belt level?
Your answer
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