Ipoh Private Lesson RSDJKD Registration Form

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Urban Street Defense's Reality Street Defense (JKD) - PRIVATE LESSONS

REGISTRATION FOR (IPOH) STUDENTS ONLY
Registering for how many person?*
Name*
If Registering For More than 1 pax, can fill in their names after comma
When would you like to begin your lesson?

MonthDayYear
Date
Age*
If Registering For More than 1 pax, can fill in their age after comma
Phone Number*

Area CodePhone Number
4 PRIVATE LESSONS - RM2888 PRIVATE LESSONS - RM488 (SAVE RM88)12 PRIVATE LESSONS - RM688 (SAVE RM176)
Any martial arts background? If yes, let us know which martial art & years of practice. *
Do you have any physical conditions that we should be aware of before you start training with us?*
to beat up a personlearn skills which are stress tested in realitysimple & direct ways to defend yourself in realityfancy moves for performance / showwin competitionsOther
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Urban Street Defense's Reality Street Defense (JKD) - PRIVATE LESSONS