White Belt Martial Arts Course Registration

White Belt Course Registration

Be sure to completely fill out the form below and proceed all the way to the checkout page. If you do not fully complete the form and payment, your registration is not complete.

General Information

Release Forms

Payment

* Indicates required field

Student's Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Contact Email *

Gender *

Birthdate *

Age *

Marital Status *

Number of Children *

Occupation *

Education Level *

Reason for Starting Training *

Session *

Goals for Training *

Issues that may Impact Training *

Additional Comments *

Photo and Emails opt out *

Do not use my photo (internal photos will still be taken for personal development) Do not add my name to email distribution lists (this includes all newsletter notifications) Do not share with partners (this opts out of educational material from National Level Instruction)

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"Challenge life. Do not wait for life to challenge you."
-Traditional Martial Arts Principle

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