Zenyo Jiu Jitsu Kids Trial Class
Participant Name
*
First Name
Last Name
Additional Participant
First Name
Last Name
Parent or Guardian Name
*
First Name
Last Name
Trial Class Option: Select One
Children 8 and older :: Thursday 5:30 P.M.
Children 8 and older :: Sunday 10:45 A.M.
Trial Class Option: Select One
Children 5,6,7 :: Wednesday 5:30 P.M.
Children 5,6,7 :: Sunday 10:00 A.M.
Date You Would Like Trial Class
*
-
Month
-
Day
Year
Date
See Zenyo Schedule
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact
*
First Name
Last Name
Emergency Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Signature
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Please verify that you are human
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