Test - Victory Defense Systems

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Registration Form 2024-205

* indicates required

Contact Email Address *

Student First Name *

Student Last Name *

First Name of Parent of not 18

Last Name of Parent if Student not 18

Contact Phone Number *

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Text to Phone *

Yes
No

Emergency Contact - First Name *

Emergency Contact - Last Name *

Emergency Contact Phone Number *

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

Media Release Agreement *

Agree to Media Release
Do Not Agree to Media Release

Health Conditions?

Tuition Policies - Please Initial Below *

PayPal Email if different than above

PayPal Name First Last if Different

How did you hear about the program?

Why does the Student wish to join the class?

Fun
Confidence
Fitness
Social
Stress Reducer
Desires to Learn Kung Fu
Self Defense

Acknowledge and Release Form - Initial Below *

http://eepurl.com/hncZar

Classes / Programs

Future Tiger Kids Martial Arts
Tiger Kids Martial Arts
Keep S.A.F.E.
Wing Chun Kung Fu
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Victory Defense Systems
Tiger Kids Kung Fu - Akron Wing Chun - Keep S.A.F.E. Self Defense - Onsite Programming
Copyright © 2024 I [email protected]

Welcome
Get Started
Classes
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About
T-Shirt Store