Contact Us
Use this form to enquire about Ballina Coast Miyagi Kan classes and membership
Enquirers Name
*
First Name
Last Name
Childs or Students Name
First Name
Last Name
The age of the student
this enquiry is about.
Contact Number
*
E-mail
*
I'm Enquiring for what location?
*
Please Select
Ballina (Richmond Room)
Lennox Head (Community Hall)
Has the enquirer done karate or a Martial arts before?
*
Please Select
Yes Karate
Yes other
No I am brand new to it all
How would you rate your or their fitness? On a scale I am
*
Please Select
Awesome
Pretty good
I've been slipping
Not great
Address
*
Street Address
Street Address Line 2
City
State
Postcode
Type a question,
*
We really appreciate your enquiry, please give us time to get back to you. We hope this is the first step of many on your journey to a karate black belt.
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