Fighting Griffin Family Karate
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Student Name (First & Last) *
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What is the date you plan to come to your first class? (check our schedule online for appropriate class)
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Program *
2 week trial memberships begin on the first day the student attends class. Please confirm how the fee of $35 will be paid. *
Student Date of Birth *
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Student Age *
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Gender
Parent Name (First & Last) if applicable
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Email *
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Phone number *
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Address *
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Any medical conditions we should be aware of?
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How did you hear about us? Google search? sign? Facebook? Referral (who?)? *
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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. *
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