Kokoro Dojo Free Class Trial Registration

Kokoro Dojo Free Class Trial Registration

Come out and try 1 free class! If you are wanting to register more than one child, please fill out a form for each child separately.
Signatory / Parent / Guardian*

Last NameFirst Name
Member - Child*

Last NameFirst Name
Date of Birth*

DayMonthYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal
Telephone Number (Landline)

Area CodePhone Number
Mobile*

Area CodePhone Number
Email*
example@example.com
Acrobatics & PowerMoves / 16 yrs + / 10:00-11:15Brazilian Jiu-Jitsu / 16 yrs + /10:00-12:00Jiu-Jitsu / 16 yrs + / 10:00-11:30Jiu-Jitsu Kids / 4-5 yrs / 14:30-15:00Acrobatics / 7-13 yrs / 15:00-16:00Jiu-Jitsu Kids / 6-7 yrs / 15:15-16:00Little Dragons / 4-5yrs / 14:15-14:45Little Dragons / 4-5 yrs / 15:30-16:00Parents and Tots / 2 yrs + / 16:15-16:45Little Dragons / 6-7 yrs / 16:15-16:45Karate Kids / 7 yrs + / 17:00-18:00Jiu-Jitsu Kids / 8-12 yrs / 17:00-18:00Drachenjäger / 7-12 yrs / 17:30-18:30Karate Teens / 12 yrs + / 18:15 - 19:15Jiu-Jitsu Teens / 13 yrs + / 18:15-19:15Taekyun / 13 yrs+ /18:45-19:45Isshin Ryu Karate / 16 yrs + / 19:30-21:30Jiu-Jitsu / 16 yrs + / 19:30-21:30Taekyun (Yetbeop) / 16 yrs + / 20:00-21:00Other
Allergies or Medical Conditions Relevent to Training
Additional Questions/Requests
Confirmation
We will contact you as soon as possible with a time for your free trial lesson. Should we not have a space free in your chosen course, we can place you on our waiting list and contact you again as soon as a space becomes available.
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Kokoro Dojo Free Class Trial Registration

Confirmation