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Please fill out a waiver prior to coming to class.
Child's Name
Last Name
Email Address
Date of Birth
Street Address
City
Postal / Zip code
Today's Date
Phone
What you would like your child get get out of the program
*
Discipline
Focus
Respect
Self Confidence
Self Control
Fun
Self Defense
Does your child have an medical problems or issues that the teacher should know?
I understand that at any point I cannot walk onto the Dojo mat; speak to my child while class is in progress; be disruptive or have any loud disruptions while class is in progress; be disrespectful to other parents, staff/sensei or someone else's child; ask for promotions/stripes
I accept terms & conditions
Lialibity Waiver
Covid-19
Your Signature
Clear
Submit
Thank you!
This portion is only for those who are enrolling.
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