Student Application 2026

Student Application 2026
Name of Student

First NameLast Name
Nickname of student (if applicable)
How old is your kid?
Date of Birth

MonthDayYear
Date
USE WHEN SIGNING UP MULTIPLE STUDENTS:
First Name   Last Name   Date of Birth
First Name   Last Name   Date of Birth
First Name   Last Name   Date of Birth
Name of Parent or Legal Guardian

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of 2nd Parent or Legal Guardian (if applicable)

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Student
Does your kid/s attend any other types of Martial Arts, boxing or sports? If so, please specify:
Medical Treatment Authorization Form

This form grants temporary authority to a designated adult to provide and arrange for medical care for a minor in the event of an emergency where the minor is not accompanied by either parents or legal guardians, and in the event it may not be feasible or practical to contact them.
Allergies(Other): Please note any conditions (adhd ect) for which the child is currently receiving treatment for. This helps us with teaching them. If you have multiple kids please specify.
Let us know of any behaviors that will help us to better teach our new student/s. If you have multiple kids, please specify.
PARENT VIEWING AREA RULES
MONTHLY TUITION
Name of Parent

First NameLast Name
Signature
Name of 2nd Parent (if applicable)

First NameLast Name
Signature
Should be Empty:

Student Application 2026

PARENT VIEWING AREA RULES

MONTHLY TUITION