Student Registration Form

Student Registration Form
Name of Student*

First NameLast Name
Name of Parent*

First NameLast Name
Parents'/Guardians' Phone Number*
Please enter a valid phone number.
Email*
Student's Date of Birth*

MonthDayYear
Date
Gender*

MF
Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Day and Time Slot*
Which school is your child attending?
Anything you want us to know about your child?
What change(s) do you want to see in your child through learning Taekwondo?
How did you find out about us?*

LeafletsFriendsSearch EngineSNS (Facebook, Instagram)Pass-byOther
INJURY WAIVER

The student, the parent, or the legal guardian on behalf of the student, acknowledges and is fullycognizant of all the inherent dangers in connection with the execution of Taekwondo andacknowledges that Taekwondo requires physical exertion and contact, and realizes that there is arisk of physical injury which may be incurred while engaged in this activity. The student, parent, orlegal guardian on behalf of the student, hereby waives any and all claims for any physical injury inconnection with the training at the school and expressly assumes the risk of all dangers or injuryinherent to Taekwondo.
I, the student/ guardian of the student, acknowledge that I agree to the above agreement and further affirm that the student is in good health. By signing below, I also agree to abide by all rules and instructions given by the instructors.*
Signature*

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