Karate Class Ongoing Every Wednesday
Fill out the form carefully and sign up of each participant.
Class Date
December 4
, Wednesday, 5:30 - 6:30pm
Class Date
December 4, Wednesday- Yellow/Orange Belts, 6:30 - 7:30pm
Class Date
December 11 , Wednesday, 5:30 - 6:30pm
Class Date
December 11, Wednesday- Yellow/Orange Belts, 6:30 - 7:30pm
Class Date
December 18 , Wednesday, 5:30 - 6:30pm
Class Date
December 18, Wednesday- Yellow/Orange Belts, 6:30 - 7:30pm
Class Date
November 20
, Wednesday, 5:30 - 6:30pm
Class Date
November 20, Wednesday- Yellow/Orange Belts, 6:30 - 7:30pm
Class Date
October 23, Wednesday, 5:30 - 6:30pm
Class Date
October 23, Wednesday- Yellow/Orange Belts, 6:30 - 7:30pm
Class Participant Name
*
First Name
Last Name
Gender
*
Male
Female
N/A
Age
*
Ethnicity
*
Hispanic/Latino
African American
Asian
White Caucasian
Other
City where you live
*
Number in Household
*
Number over 62
*
Family/Parent/Guardian Name
*
First Name
Last Name
E-mail
*
Mobile Number
*
-
Area Code
Phone Number
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December Monthly Family Donation
$
50.00
December Monthly Family Donation
December IRC Reimbursement
$
50.00
IRC Reimbursement Payment for Recreational Services, Basketball, Dance, Karate, Soaring Eagles
December Monthly Family Donation
$
75.00
December Monthly Family Donation
December IRC Reimbursement
$
75.00
IRC Reimbursement Payment for Recreational Services, Basketball, Dance, Karate, Soaring Eagles
December Monthly Family Donation
$
100.00
December Monthly Family Donation
December IRC Reimbursement
$
100.00
IRC Reimbursement Payment for Recreational Services, Basketball, Dance, Karate, Soaring Eagles
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Total
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0.00
Payment Methods
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