Give us an idea of when you'd like to start your 2 week trial

Student Name (First & Last) *

Gender

Student Age *

Student Date of Birth *

Program *

2 week trial memberships begin on the first day the student attends class. Please confirm how the fee of $35 will be paid. *

Please let us know how you would like to participate *

Parent Name (First & Last) if applicable

Phone number (emergency contact) *

Email (provide up to 2 email addresses so that we may keep you up to date) *

Address *

Any medical conditions we should be aware of?

How did you hear about us? Google search? sign? Facebook? Referral (who?)? *

All of our online classes use Zoom. If you need some assistance getting set up, please let us know. *

Included in your 2 week Online Trial is a uniform (gi). We'd be happy to deliver one to your door. Please give us an idea of your size.

I hereby consent to the application and its terms and conditions and in consideration of acceptance, I hereby agree to indemnify and save harmless Fighting Griffin Family Karate Martial Art Center and its officers, members and authorized guests from any and all liabilities of any kind whatsoever, of any nature, arising out of any form and connected with any kinds of claims or demands made on my behalf or the applicant. Some photographs of students may be used on our social media accounts. No names will ever be used. *

Once you submit this form. Sensei Karen will be in touch with you to get you going. We look forward to meeting you :) *