Student Qualification Form
Adult, Please Enter Your Name:
If for your child, what is your child's name?
Do I qualify to become a student?
I (or my child if applicable).....
Live close enough to HTKD to attend classes regularly
Have suitable transportation
Can afford to budget tuition costs
Have the desire to become a BlackBelt
Could commit to a 12 month course if I chose to do so. (adults commit for the child)
Am cleared for physical activity by a doctor
Have health insurance
Am between the ages of 5 and 95?
I am most interested in:
Becoming a BlackBelt
Improved Health and Fitness
Making a Positive Impact on Others
About myself or my child:
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