Kane Academy Open day lesson booking form. 
For all programmes running at the Kane Academy
HALF PRICE Uniform If you sign up on the day. 

Come try the lesson for free and chat to one of the team. 

We can't wait to help you! 
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"Remember... You don't have to be the big guy!" Sifu Rebecca Kane
Which programme are you wishing to book onto? *
Student Name *
Date of Birth *
EG: 03/02/1993
Mobile Number *
Email Address *
Address *
Emergency Contact Name *
Emergency Contact Number *
Medical Conditions *
Do you suffer or have you suffered from any of the following?
If you have selected any of the above, please provide further details.
How Did You Hear About Us? *
Please tell us why you want to join. *
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