KPO Registration Form

Student Name

First NameMiddle NameLast Name

Birth Date

MonthDayYear

Age

Ages 6 & Up

Phone Number

Example (888)123-4567Format: (000) 000-0000.

E-mail

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Any Physical Limitation(s)? Please List Below.

Type "None" If there is no Physical Limitation(s).

Parent/Guardian 1 *(Required for Students Under 18 Yrs Old)

First NameLast Name

Relationship to Student

Phone Number

Format: (000) 000-0000.

Parent/Guardian 2 (Optional)

First NameLast Name

Relationship to Student (Optional)

Phone Number Parent (Optional)

Format: (000) 000-0000.

How did you hear about us?

Please Read Rules & Regulations in Full

Rules & Regulations

Class Schedules for Waialua & Aiea Locations

Open Enrollment is for the next 6 months Term (July-December)

All Classes will start either 7/6 Monday or 7/7 Tuesday, Which ever day your class lands on.

*Waialua Location:

St Michaels Church Hall (67-390 Goodale Ave, Waialua Hi 96791)

*Notes- You may park in front or side off church. Hall is behind the church.

Monday 4:00p-5:00p Vahine & Tane Class (Women & Men, Ages 13 & Up)

Monday 5:00p-6:00p Tamari'i Class (Boys & Girls, Ages 6-12 Girls)

Monday 6:30p-7:30p Hula Wellness Class (Women Ages 13 & Up)

Tuesday 6:30p-7:30p Hula Wellness Class (Women Ages 13 & Up)

*Aiea Location:

Aiea District Park (99-350 Aiea Heights Dr, Aiea Hi 96701) *Notes- Parking is limited. You may park in designated parking lot or street side parking.

Tuesday 5:15p-6:15p Tamari'i Class (Boys & Girls, Ages 6-12 Girls)

Tuesday 6:30p-7:30p Vahine & Tane Class (Women & Men, Ages 13 & Up)

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Class Tuition Fees

$35 Annual Registration Fee (Only Discount 2 or Hula Wellness Class Annual Registration fee is waived.)

$65 Monthly/Per Student (Choice of Mondays or Tuesdays, Includes 4 Classes)

(Discount 1) $50 Monthly/Family Sibling Rate (Choice of Mondays or Tuesdays, Includes 4 Classes)

(Discount 2) $25 Monthly/Per Parent (Parent Rate Per mom or dad with an active Registered Child, Registration fee waived. Covers only Monday or Tuesday Classes-4 Classes. $50 Monthly per parent if wanting to attend both Monday & Tuesday classes- 8 Classes)

(Discount 3) $100 Monthly/Per Student (If student would like to attend both Monday & Tuesday Classes, Includes 8 Classes)

$10 Per Class/Hula Wellness Class (Registration fee is waived)

$15 Registered student wanting to attend a 2nd class for the week. For Example, Student attends Mondays regularly but only can attend one Tuesday class. They will then pay $15 for Tuesday along with their monthly payment.

$25 Drop In/Trial Class (Per Person, Not Registered Student)

Additional Fees (Student may purchase in class at the sign in table)

$45 KPO Jersey
$25 KPO Black Pareo
$20 Pair of Poi
$5 Class Flower

Questions? Text us at (808)778-0419

Which Classes are you interested in attending?

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Annual Registration Fee

Pay One Time Per Year. Unless you are paying for discount 2.

$35.00

1st Month Tuition (Monday or Tuesday Class)

Applied to the first month the student attends class

$65.00

(Discount 1) 1st Month Tuition-Family Rate

For immediate Family/Siblings enrolling two or more students

$50.00

(Discount 2) 1st Month Tuition-Mom/Dad

Parent Rate for both mom and dad. Select quanity if one or two parents will be joinging the class. Aannual registration fee will be waived.

$25.00 Quantity

(Discount 3) 1st Month Tuition-Monday & Tuesday Classes

Applied to the first month if student wants to attend both Monday and Tuesday Classes

$100.00

Hula Wellness Class

1st Class Tuition for Monday or Tuesday

$10.00

Drop In/Trial Class

One Time Drop In/Trial Class

$25.00

Subtotal

Tax

Total

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Kalena's Polynesian Ohana Student Registration Form

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