Boston Kokikai Aikido
Welcome To Kokikai Aikido Boston, Inc! Your journey starts today!
Form Instructions: To Sign Up for the Beginner's Course or Regular Adult Membership please fill out the form. If you are requesting information only Required Fields (orange *) are necessary. Please place any comments in comment box at bottom of the form. If you are unable to complete this form please feel free to contact us at info@kokikaiboston.com or 617/910-4700.
Personal Information
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Aikido Specific Information
Main Interest
Mind/Body Coordination
Japanese Arts
Self Defense
Physical Fitness
Other
Please explain if "other" is chosen from above
Previous Martial Arts Experience (not required!)
None
Aikido
Other Martial Art
Program Type
*
Adult Beginner's Session
Family Beginner's
Session
Adult - Regular Membership
Information Only
Aikido Kokikai Rank
none
6
5
4
3
2
1
Dan
Contact Information
Address
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Medical and Emergency Information
If yes describe condition briefly
Do you have any allergies, physical limitations, or medical conditions of which the dojo should be aware with regard to your safety while training or the safety of others?
*
No
Yes
Emergency Contact Name
Emergency Contact Phone
Uniform Ordering Information
Height
Weight
Body Size (for uniform ordering)
X-Small
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XXX-Large
Dates and Times
Available Days
Monday 6:30-8:00pm
Tuesday 7:30-9:30pm
Wednesday 6:30-8:00pm
Thursday 7:30-9:00pm
Sunday 11:30am
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Beginner Course - Six Weeks Includes Uniform!
$
169.99
friend/family joining with you (save 70.00)
$
99.00
Pre-Payment Beginner\'s Course
$
50.00
Enter coupon
Apply
Total
$
0.00
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Problems or questions about this form? Please contact us at info@KokikaiBoston.com or (617) 386-9505 .
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