A.T.A. ONLINE PROGRAM
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STUDENT INFORMATION
Photo of Student
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Name of Student
*
First Name
Last Name
Age
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Gender
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Male
Female
Location
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House / Unit Number and Street
Village and Barangay
City
Province
Postal / Zip Code
Mobile Number
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Please enter a valid phone number.
Email Address
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Confirmation Email
example@example.com
Any diseases, disorders, previous injuries, and/or disabilities?
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PARENT / GUARDIAN'S INFORMATION
FOR MINORS ONLY
Name of Parent
First Name
Middle Name
Last Name
Mobile Number
Please enter a valid phone number.
Email Address
*
example@example.com
RULES & REGULATIONS OF AMPONGAN TAEKWONDO ACADEMY
Parent / Guardian's Signature
*
Student's Signature
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