MMA Striking Class Registration

MMA Striking Class Registration

Sign up to participate in our MMA striking course. Please fill out all required information below.
Full Name*

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

MonthDayYear
Date
Do you have any prior experience with MMA or striking arts?*

No experienceBeginner (less than 1 year)Intermediate (1-3 years)Advanced (3+ years)Other
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Please list any medical conditions or injuries we should be aware of
How would you like to pay?*

Cash.appPayPalVenmoCash
How would you like to purchase your sessions? I offer a drop-in rate at $45 or opt for a monthly plan at $120.
Choose your payment plan*

Drop-in $45Monthly $120 (4 Sundays)
I understand that participating in boxing and MMA training involves physical activity and risk of injury. I voluntarily agree to participate and assume all risks associated with training.

I agree to follow all gym rules and instructions given by the coach. I understand that failure to do so may result in removal from class.

I hereby release and hold harmless Amdis Boxing, its coaches, and affiliates from any and all liability, claims, or demands arising from participation in training.
Signature
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