INQUIRY form

Participant's First Name *

Participant's Last Name *

Participant's Birthday *

Gender *

Phone *

Email *

Address

Street Address *

City *

State *

Country *

Postal code *

How did you happen to hear about us? *

Referred By / Other (if applicable)

Guardian's First Name

Guardian's Last Name

Guardian's Birthdate

What motivated you to come in today? *

How long have you been interested in taking Martial Arts?

Are you (or your child) currently involved in any other activities at this time?

Yes

What days/times are good for you (or your child) to train/workout?

How often does it occur in a week? Please specify the days and times.

Do you (or your child) have any previous martial arts experience?

What’s one personal challenge or area of growth you (or your child) are currently working on that martial arts could help support? (Examples: focus, confidence, discipline, emotional control, listening skills, respect, motivation, healthy routines, stress relief, consistency, work-life balance, goal-setting, or mental clarity)

Are there any medical conditions, injuries, or physical limitations that may affect your (or your child) ability to participate in physical activities? If yes, please explain.

Student 2 Name

Student 2 Birthdate

Student 2 Gender

Student 3 Name

Student 3 Birthdate

Student 3 Gender

Student 4 Name

Student 4 Birthdate

Student 4 Gender

The undersigned understands the risk of studying Martial Arts and hereby releases Martial Arts International, all its instructors and other students of from any and all liabilities, for any type of injuries or loss sustained while training, studying, practicing or in the application of Martial Arts or Karate. The undersigned also states that he/she is in good physical condition and knows of no reason why he/she (or his/her child) cannot study and participate in Martial Arts.

In the event of an emergency, I hereby authorize any licensed medical personnel to perform any accepted medical procedure deemed necessary and agrees to bear the expense of any such treatment. I HAVE READ AND UNDERSTOOD THE ABOVE AND WOULD LIKE MYSELF (OR MY CHILD) TO TRY A LESSON AND OTHERWISE PARTICIPATE IN MARTIAL ARTS LESSONS.

Date Today *

Signature *

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