Welcome to Karate with Sensei Susan at Volunteer Pool Community Centre
Please fill in the form below
Student's Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Date of Birth
*
-
Month
-
Day
Year
Phone Number
*
-
E-mail
*
Emergency Contact
*
First Name
Last Name
Phone Number
*
-
Winter Session: January 8-May 4th, 2025 (students can start anytime and registration will be pro-rated) Class Time:
*
Wednesdays 4:45pm-5:30pm $285 plus HST ($322.05)
Wednesdays 5:30pm-6:15pm $285 plus HST ($322.05)
Sundays 10:00am-10:45am $285 plus HST ($322.05)
Sundays 10:45am-11:30am $285 plus HST ($322.05)
Sundays 11:30am-12:15pm (Adults/Teens) $285 plus HST ($322.05)
Attend Twice per Week for $395 plus HST ($446.35) (email susan@senseisusan.com indicating your class times)
Family Class (for 2-12 year olds and their caregivers): Sundays 12:15-1:00pm *January 12-March 2 $120 plus HST ($135.60) or $20 drop in
Uniform ($45)
Yes
No
Price
CAD
Method of Payment
E-Transfer (susan@senseisusan.com)
Cash or Cheque (Payable to S. Baldassi)
Are there any health concerns/information that you feel we should know about?
How did you hear about our program?
Social Media
Posters
Recommend by Friends/Family
Other
Back
Next
Signature
Total
Submit Form
Should be Empty: