Three Elements Karate Club Registration Form

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Email *

Participant #1 Full Name *

Gender *

Birth Date *

YYYY

Which class are you registering for? *

Current Rank (white if a new student) *

Describe any medical conditions that could affect Karate training: *

Passbook

Do you require a new passbook? Please check to see if the page with your stickers is full. If it is, or if you no longer have your passbook, select "Yes", otherwise, "No".

If you are new to the club, please select "Yes"

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