Registration

To register, please fill out the information below. All Fields are required.

First Name

Last Name

Phone

Address

How Many Students?

Students names and ages.

Registration fees - One time fee for new members to set up your account. Includes t-shirt, belt and pants for class, plus one tThe Fundamentals of Martial Arts DVD. $129 for first family member, $109 for each additional family member. Membership fees: due on a monthly basis. $99 for the first family member, $155 for two family members, $50 for each additional member

I agree to sign up and pay on a monthly basis untill I request a cancellation through the American Karate Academy. Cancellation requests must be given at least 30 days prior to the monthly payment date. I agree to receive my monthly invoice through email. I agree to submit payment online or allow American Karate Academy to keep my credit card on file to charge monthly for the amount due. I agree that if I do not pay the monthly dues ontime there will be $10 late fee added to the amount due.

I understand that any athletic activity carries with it the risk of injury. I knowingly, willingly and voluntarily assume these risks for all students joining the training under my supervision. I agree to not hold The American Karate Academy, Inc., its owners, instructors, employees, agents, or students liable for any property damage, harm, or injury resulting from participating in the traning.

Yes

Date

Time

Your Signature

Registration

To register, please fill out the information below. All Fields are required.

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