General Registration

Please indicate what you would like to register for:

Tai Chi Chuan

Kung Fu

Chi Kung

Kung Fu for Kids

Way of the Sword

Meditation

Seminar

(Please indicate the seminar title in the detail line below.)

Seniors

Women's Wellness Journey

(Please use Women's Wellness Weekend Registration Form.)

Detail (optional)

Program Location

Name

Cell Phone / Landline: Specify

Address (include Postal Code)

Birthdate

Occupation

Emergency Contact ( Name & phone number)

Please indicate your general health or any health concerns we should know about.

What do you hope to gain from this program?

yes

Previous Martial Arts or fitness experience?

How did you hear about Temple Knights? (optional)

Search Engine

Social Media

Friend

poster or flyer

Other

Would you like to receive our monthly email newsletter?

Additional Comments (optional)

Waiver: (To be signed when you attend your first class). By signing this registration form I certify that the above information is correct. As as participant, I acknowledge that Temple Knights Martial Arts and their representatives shall in no form be liable or responsible for injury, bodily harm occurring to me during classes and that such risks shall be borne by me voluntarily. Our policy after registration payment is made is no refunds except for medical reasons. However, makeup classes, credits or credit transfers for products or membership can be arranged. (optional)

Date: (optional)

Signature or Guardian's signature: (optional)