Kaizen Dojo: Online Application Form 26

Kaizen Dojo: Online Application Form

Please scroll down the form, execute all parts and press "SUBMIT".
Kaizen Dojo is an after school program operated by Kaizen Karate. We are located at 9545 Georgia Ave, Silver Spring, MD 20910 (near the beltway exits). Students will take part in daily karate lessons, snack time, homework time, and more!

*We follow the MCPS calendar. Service will be provided on 1/2 days.

Questions - email coach.v@kaizenkarateusa.com
Student's Information
Name

First NameLast Name
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Child's Grade:
Name of school student attends
What time does your child get out of school each day?

Hour Minutes

AM/PM Option
Do you need van service?
Attendance Days
Parent/Guardian Information
Parent 1

First NameLast Name
Parent 2

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
Tuition Information

Invoices will be sent to parents on the 25th of each month. Payments for Kaizen Dojo services must be made by the 5th of each month, by parents, through electronic invoice and powered by Intuit QuickBooks. Payments may be made by credit or debit card.
Tuition rates below
*Starting in Fall 2026, all invoices were placed on auto-pay. You may cancel at any time.

*Drop-in service - $40 per day - if this service is needed, we request an email at least 24hrs in advance when possible or call our office directly.
By signing below, I agree to the tuition rates outlined above. I understand that Kaizen Karate will bill be electronically on a monthly basis. I also understand that further information may be requested.
Should be Empty:

Kaizen Dojo: Online Application Form

Student's Information

Parent/Guardian Information