Shaolin Martial Arts Signup

Location:*

Sausalito, CaAlbany, Ca

I want to train in:*

Kung FuTai Chi Chuan

Name*

First NameLast Name

Parent/Guardian

First NameLast Name

Gender*

MaleFemaleOther

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Birthday*

MonthDayYear

Age

I understand that my payments continue even if there is a break in my attendance.

The student or guardian should notify the Golden Lion Sausalito Martial Arts of missed weeks.

I understand there is no refund for any fees or tuition paid.

In Studio Training:

Click class to pay online or paypal @shaolin31

Payment can also be collected at the studio. Credit cards (mastercard and visa) or cash accepted.

Fees (Please select one training plan):

Kung Fu - Cubs ages 4 1/2 to 6 years ($255 Initial, $145 Monthly)Kung Fu/Tai Chi Chuan ($345 Initial, $195 Monthly)2 Days Introductory Program - $45 (free t-shirt Introductory fee will be applied towards initial signup tuition)Drop in - $35 per session6 months or 12 months paid in full, discounted.Gift Certificate

Office Use Only: Paid cc _____ ck _____ cash ______ other ______

Rights of Cancellation:

You may cancel this agreement within 3 business days from the start date without penalty or obligation.
If student becomes disabled for at least 2 months during the membership terms and that disability is confirmed in writing by a physician, you have a right to an extension or cancellation of this agreement.
30 days notification of cancellation of above training program, either written and delivered or emailed with a reply.

* Until terminated by student or studio with no further obligations.

Waiver:

The student hereby represents that he is physically fit to take the prescribed course of instruction. The student further acknowledges that the existence of some risk of personal injury in participating in said prescribed course of instruction, and that the student is assuming this risk without liability to the school, owner, instructors, family members or Landlord, by executing this agreement and participating in said course of instruction.

The student and guardian acknowledge any videos or pictures taken of said student is for marketing purposes only. No monetary or material is given. Please inform the studio if you wish to opt out from any pictures or videos taken.

Date

MonthDayYear

Please sign to authorize training

Golden Lion Sausalito Martial Arts Application Form