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Get Started on your Kung Fu Journey at Academy of Young Minds - North!

To enroll your Student in Class there is 2 sections - both need to be completed

Section 1 - Mailchimp Email Subscription

Please fill out field and click subscribe and then move to Section Two.

Section 1 - Email Subscription Form Only

* indicates required

Contact Email Address *

Student First Name

Student Last Name

Contact Phone Number

() -(###) ###-####

Section 2 - Enrollment Information and Agreements

Please fill out these fields and click the submit button, which finishes the enrollment and will take you to a confirmation page.

Contact Information

* Indicates required field

Student Name *

First

Last

Parent Name if under 18 *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Primary Email - one that you check daily *

Primary Cell Number *

Text to your phone? *

Yes No

Emergency Contact Information

Name *

First

Last

Relationship to Student *

Phone Number *

Class and Student Specific Information

Future Tiger Kids is for Student from 3 to 6 yrs old
Tiger Kids is for Students from 7 to 13 yrs old

Program Interested in *

Does Student have any health conditions, injuries or allergies we need to be aware of? Please explain *

Why does the student want to enroll in our class? *

Fun Confidence Fitness Social Stress Reducer Desires to learn martial arts Self Defense

How did you hear about the program? *

Media Release Agreement

I hereby grant Victory Defense Systems permission to use my or my child’s likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.

Please choose your Response to the Photo Release *

Agree to Photo/Video Release Do not Agree to Photo/Video Release

Acknowledge and Release Form

I have read and understood the Acknowledge and Release Form (click to read)

Initials for reading and understanding the Release Form *

Initials for First and Last Names

Tuition Policies - Updated Recently in the Victory Defense Systems Handbook

I have read, understood and will be held accountable to the Tuition Policies in the Victory Defense Systems Handbook.
Click here of for the Victory Defense Systems Handbook
Click here specifically the Tuition Policies

Initials for being held accountable to current Tuition Policies. *

Initials for First and Last Names

PayPal Contact Info - if different than above

Please fill out your PayPal Account contact info if it is different than your registration. If it is different, it can be extremely hard to link the subscription to the student. Thank you for providing this info to make this process easier.

Name used on PayPal Account if different than above *

First

Last

Name Used on PayPal

Email used on your PayPal Account if Different than Above *

Phone Number on your PayPal Account if Different than Above *

Signing and Submitting

By signing below, I am agreeing and obligated to both of the Acknowledge and Release Form, the Tuition Policies and all other policies in the Handbook.
Click here of for the Victory Defense Systems Handbook

Please type your name to agree with the Victory Defense Systems Releases & Policies *

I agree to receiving marketing and promotional materials

Submit

After clicking submit, you will be taken to a confirmation page and where you can sign up for your PayPal Tuition Subscription.

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