• Child 

    Participant

    Form

    For All Participants

    17 & Under 

     

  • Todays Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Parent Contact Information

  • Format: (000) 000-0000.

  • Child Information

  • Gender

  • TRAINING EXPERINCE

  • Has your child ever trained in any martial arts or self-defense before?*

  • TRAINING INTEREST & GOALS

  • Was taking martial arts your child’s idea, your idea, or shared?*
  • What are the main reasons why you want your child involved in martial arts? Select the ones that apply:*
  • Which best describes you right now? Please Select one*
  • If Researching? Please Select one*
  • If you found the right place. Are you prepared to start right away? Please Select one*
  • what does the right place look like to you? Select all that apply*
  • What classes are you interested in for your child? Please Select one*
  • What training commitment do you feel most comfortable with? Please Select one*

  • TRAINING AVAILABILITY

  • Is your child currently involved in any sports or activities?*
  • If yes, will it interfere with their ability to attend classes on a regular schedule during the next 12 months?*
  • When your child normally participates in sports or activities?*
  • Since this would be their first ongoing activity, are you willing to help them stay consistent after the initial excitement wears off?*
  • Is your child planning on participating in anything in the future that could possibly prevent them from attending class during the next 12 months?*
  • Is your child planning on permanently moving during the next 12 months?*
  • Is your child planning on leaving the area for either a short time period or for an extended period of time within the next 12 months?*
  • When are you realistically planning to start classes for your child?*

  • TRAINING BUDGET

  • Have you set aside a budget for your child's training?*
  • About how much have you budgeted per week?*
  • Our memberships generally range between $40–$80 per week. Is that comfortable for you?*
  • Can you comfortably budget between $40 to $80 each week for your training?*

  • LOCATION

  • What part of town are you coming from?*

  • DECISION MAKERS & SUPPORT

  • Will another parent or guardian also be involved in the enrollment process?*
  • Format: (000) 000-0000.
  • is there anyone else you need to consult with before enrolling your child for classes?*
  • If yes or no, select one:*

  • HEALTH & SAFETY

  • Does your child have any physical limitations or injuries that we should be aware before they start training?*
  • Does your child have any medical conditions, or special considerations we should be aware of before they start training?*
  • Is your child currently taking any kind of medication?*
  • If yes, will the medication affect physical activity, balance, focus, or participation during training?*

  • TRAINING COMMITMENT

  • What type of workout are you interested in for your child? Select one:*
  • How many days a week would you like your child to attend classes? Select one:*
  • What are the best days for your child to attend classes? Select any that apply*
  • What are best times for your child to attend classes? Select Any*
  • Is earning a Black Belt something your child is interested in?*

  • CARD-ON-FILE ACKNOWLEDGMENT

  • I understand that a valid credit or debit card is required to reserve my Complimentary Introductory Class and that my card is not charged when booking.*

  • CANCELLATION & NO-SHOW POLICY

  • I understand that a $30 fee per participant applies if I do not attend my scheduled class or cancel/reschedule less than 24 hours before the scheduled class. If I book within 24 hours of the class, the $30 fee applies if I cancel or do not attend.*

  • DECISION-MAKER POLICY

  • I understand that all decision-makers involved in enrollment are required to attend the Introductory Class and enrollment meeting. If a required decision-maker does not attend, the appointment will not qualify as a Complimentary Introductory Class and the regular $30 Introductory Class fee per participant will apply.*

  • COMPLIMENTARY CLASS TERMS

  • I understand that the Complimentary Introductory Class is intended for prospective students who are seriously considering starting ongoing martial arts training within the next 7 days or sooner if Portland Academy is the right fit.*

  • COMPLIMENTARY INTRODUCTORY CLASS RESERVATION AGREEMENT

  • By signing below, I confirm that the information I provided is accurate and that I have read, understand, and agree to the reservation terms above.*
  • Today's Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Take Photo*
  • Should be Empty: