Students Name:
Students Phone Number:
Students Email Address:
Gender: —Please choose an option—MaleFemaleOtherNot Specified
Date of Birth (day month year)
Address:
Medical History / Medical Conditions:
Reasons For Martial Arts Study
FitnessSelf-DefenseDisciplineFunSportsWeight LossStress Relief
Other:
Guardian/Parent Name:
Guardian/Parent e-mail:
Guardian/Parent Phone Number:
I understand that under the terms of this agreement, Manotick Martial Arts obligates itself to furnish me with competent instructors and suitable facilities for teaching the lessons. The regular hourly tuition is $25.00 to $50.00 per hour, but a substantial discount has been provided for me by enrolling in an introductory course.
Qualified personnel trained in the procedures and traditions of Martial Arts supervise all class sessions. I waive any claim of damages against the school and its principals or instructors in any case of injury resulting from my participation in the activity.
I Agree to the above disclaimer
Signature:
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