Karate Lessons Registration Form

Student's Name

First NameLast Name

Address

Street Address

Street Address Line 2

City

Postal Code

Date of Birth

Phone Number

E-mail

Emergency Contact

First NameLast Name

Phone Number

Fall Session: September 9th-December 20th $340 (including HST) for once per week. $465 (including HST) for twice per week. Students can start anytime and registration will be pro-rated Class Time:

Class Times Per Week

Uniform ($45)

Method of Payment

Are there any health concerns/information that you feel we should know about?

How did you hear about our program?

Other

Welcome to Karate with Sensei Susan at Volunteer Pool Community Centre