JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Silat Self Defence Grading - Workshop Registration
Saturday 13th May
Firhouse Community Centre
10am - 12.30pm
Cost
Silat Grading - €35 - 1 Child
Silat Grading - €65 - 2 Children
Silat Grading - €95 - 3 Children
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name of Student Grading
*
Your answer
Email
*
Your answer
Contact Number
*
Your answer
Tick the Box of the Grade you are going for
*
Level 1 - Yellow Belt
Level 2 - Orange Belt
Level 3 - Red Belt
Level 4 - Green Belt
Level 5 - Blue Belt
Level 6 - Purple Belt
Level 7 - Brown Belt 1
Level 8 - Brown Belt 2
Other:
Required
I give full permission for my child to attend the Silat Grading on Saturday 13th May in the Firhouse Community Centre (Please fill in below)
*
Your answer
I understand that Payment must be made before Saturday 13th May. Payment can be made in the following ways. Please Tick Box
*
Cash at the evening Classes (Mon / Tues / Weds)
Online
www.PayPal.Me/guruliam
Revolute 0879956569
Required
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms