March Break Camp Registration Form

Name

Phone Number

Address: Include full address with Postal Code

Emergency Contact Name and number

Previous Martial Arts or fitness experience?

How did you find out about Temple Knights?

Would you like to receive our monthly email newsletter?

Waiver: (To be signed at your first class.) By signing this registration form I certify that the above information is correct. As a participant I acknowledge that Temple Knights 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 no refunds, except for medical reasons.. However, make-up classes, credits or credit transfers for products or membership can be arranged.

Date: (optional)

Signature or Guardian's Signature (optional)