Premium Membership Enrollment
Two Members in One Course or One Member in Two/Three Courses = $200 Monthly
Student Name
*
First Name
Last Name
Birth Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Gender
Please Select
Male
Female
N/A
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Student E-mail
*
Mobile Number
*
-
Area Code
Phone Number
Your Course
*
Please Select
Tai Chi
Kung Fu
My Products
prev
next
( X )
Premium Membership
$
200.00
Tuition runs automatically every month on the day of enrollment (if you sign up on the 7th then it will be on the 7th of every month). We do not use contracts so you can cancel at anytime.
Free Class T-Shirt Size
S
M
L
XL
XXL
XXXL
Total
$
0.00
Credit Card
In consideration for my attendance and participation at Virginia Beach Kung Fu/Tai Chi and Chesapeake, Kung Fu/Tai Chi I, the student, acknowledge the existence of certain inherent risks in this type of training and hereby agree to assume all risks. I further relieve Virginia Beach Kung Fu/Tai Chi and Chesapeake Kung Fu/Tai Chi, and fellow students, from any liability resulting from personal injury or loss of personal belongings. I also state that I am physically fit to take the prescribed course of instruction and do so of my own free will. I will seek my doctor's approval if I have any physical concerns before participating in this type of training course
*
I Agree to the Terms & Conditions above
Submit Application
Yours for Better Health, Greater Strength and Competent Skills.
Should be Empty: