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TAKE A TRIAL COURSE

TRY A CLASS

FOR FREE TODAY!

Enrolling in Premier Martial Arts has never been easier with our exclusive online offer! This includes a uniform & 2 private sessions with one of our trained instructors to help your child find the right class for them. Sign up today for this great opportunity to discover the power and benefits of our Martial Arts Programs!

    STUDENT REGISTRATION FORM

    STUDENT FULL NAME

    EMAIL

    PHONE NUMBER

    DATE OF BIRTH

    CAN WE TEXT YOU, IF NEEDED?

    GENDER

    CLASS NAME

    CLASS DATE

    ADDRESS

    CITY

    STATE

    ZIPCODE

     

    QUESTIONAIRE

    HOW DID YOU HEAR ABOUT US?

    WEBSITEDIRECT MAILPRINT ADBIRTHDAY PARTYSOCIAL MEDIAPROMOTIONAL BOOTHSIGN / DRIVE BYREFERRALTV / RADIOOTHER

    DO YOU LIVE IN THE AREA?

    DO YOU PLAN TO REMAIN IN THE AREA?

    ARE YOU OR IS YOUR CHILD IN GOOD HEALTH WITH NO PHYSICAL PROBLEMS?

    IS YOUR SCHEDULE SUCH THAT YOU CAN ARRANGE FOR YOU OR YOUR CHILD TO TAKE LESSONS TWICE A WEEK?

    DO YOU OR DOES YOUR CHILD HAVE ANY PREVIOUS MARTIAL ARTS EXPERIENCE?

    DO YOU FEEL YOUR SIGNIFICANT OTHER WOULD SUPPORT YOUR DECISION IN GETTING YOU OR YOUR CHILD ENROLLED, PROVIDED OUR PROGRAM FITS YOUR NEEDS?

     

    ON A SCALE OF 1 - 10, 1 BEING LOW AND 10 BEING GREAT, PLEASE RATE YOU OR YOUR CHILD ON THE FOLLOWING:

    FOCUS / CONCENTRATION

    12345678910

    CONFIDENCE / SELF-IMAGE

    12345678910

    RESPECT TO OTHERS

    12345678910

    FITNESS / ACTIVITY LEVEL

    12345678910

    (NOT A FOLLOWER, DOESN’T SUCCUMB TO PEER PRESSURE)

    12345678910

    INVITE SOMEONE TO TAKE A FREE LESSON WITH YOU?

    YESNO

     

    In consideration for my or my child’s attendance and participation in the martial arts training offered by Premier Martial Arts, I acknowledge the existence of certain inherent risks in this type of training and hereby agree to assume all risks. I further relieve Premier Franchising Group LLC, Premier Martial Arts International Inc., the school, it’s management, assigned staff, and fellow students from liability resulting from bodily injury, virus, any type of contagious sickness, or loss, whether personal belongings or bodily injury. I understand that member images may be used for promotional or training purposes. I agree that I or my child will not attend any event at any time when I or my child believes that they might be ill, is experiencing any symptoms of illness, or has been exposed to a person or persons known to be infected with a contagious illness. I also hereby state that I or my child is physically fit to take the prescribed course of instruction and does so of my own free will.

    NAME OF PARENT OR GUARDIAN

    SIGNATURE OF PARENT OR GUARDIAN
    (Use Mouse or Touchscreen to Sign Here)