Please fill this out for one individual, then hit submit, then if you plan on signing up more individuals, just click back and repeat the process! Name * First Name Last Name Parent/ Legal Guardian Email * Phone * (###) ### #### Address Gender * Male Female Age Birthdate Height (In Centimeters) * Belt Level * Beginner Returning White Belt Yellow-Stripe Yellow Belt Green-Stripe Green Belt Blue-Stripe Blue Belt Red-Stripe Red Belt Black-Stripe Black Belt Emergency Contact Emergency Contact Phone (###) ### #### Medical Number Family Doctor Family Doctor Phone (###) ### #### Allergies/Medical Condition(s) Payment Plan * Monthly Paid in Full (Cash) How did you hear about us? Thanks! Now, if you plan on signing up more than one person, just scroll back and fill in the form again, then hit submit again! We’ll get the form, don’t worry.
