Martial Arts Evaluation and Registration

Fill out the info below and we will call you to confirm your appointment. Please see above for any current Specials. Please list the offer code below for Special confirmation.

Offer Code*

Select Code for SpecialSummer2013

Your Name (Guardian)*

Email Address*

Phone*

Guest(s) Name*

Guest(s) Age*

Select the Program(s) You are Interested In

Adult
Teen ages 16 and Above
Teen ages 13 to 15.5
Dragons ages 8-12
Senior Tigers ages 5 to 8
Little Tigers ages 3 to 4

Evaluation Day and Time

Most evaluations can be conducted during regular class times and other available times during the day, evening and Saturday. We will contact you to confirm or set up a time that is convenient for both parties.

List preferable date and time for evaluation*

Emergency Contact Info*

Questions and Comments

Would you like to receive notifications on any special discounts, free community fun events, laser tag parties, parent night outs, clearance sales or other special events?*

Yes, PleaseNo, Thank you

Have You Trained at AK Martial Arts Before?*

NoYes

How Did You Hear About Us? Please list Media, advertisement or Referral*

Registration For Evaluation and Special

Below is an electronic release and registration form that will allow you to attend evaluations or classes without having to fill out additional paperwork (and less paper in our world is a good thing!). It is not a payment contract. Your attendance is optional and your decision.

Acknowledgement and Release Agreement

INTENT... By selecting \\\\\\\\\\\\\\\"I agree\\\\\\\\\\\\\\\" below i agree to the terms and conditions listed on this web page. I do hereby state my intent to enroll in AK Martial Arts and Fitness, Inc, dba RealFit4Life (Gym) program of martial arts instruction and will abide by the regulations, customs, ceremonies, and code of conduct set forth by the Instructors and Gym as a whole. Recognizing the strenuous nature of training activities involves risk of injury, I agree to release, defend and hold harmless AK MARTIAL ARTS and FITNESS, Inc., it\\\\\\\\\\\\\\\'s DBAs, Gym, officers, instructors, members and guests, free from all liability or damages arising out of Member\\\\\\\\\\\\\\\'s participation in the Gym\\\\\\\\\\\\\\\'s program, use of equipment, martial arts and fitness instruction. A physical examination and the permission from your doctor is recommended before commencing any type of physical training program such as this one. I understand AK MARTIAL ARTS and FITNESS, Inc. reserves the right to change hours, days and place of training any time and without notice. I understand that AK MARTIAL ARTS and FITNESS, Inc. will observe national holidays and will have the option to conduct holiday closures as designated by its\\\\\\\\\\\\\\\' officers. I hereby represents that I have no knowledge of physical condition which would render me unable to participate in martial arts training activities. I further represent and promise that in the event I becomes physically unable to participate therein, I will immediately notify the Gym in writing of same. I recognizes that regular class attendance is important for my progress and understand that it is my responsibility to attend the classes. Tigers 3 and 4 can attend a designated one or two classes per week. Senior Tigers can attend by designed group with a maximum 3 times a week. Dragons can attend unlimited classes available for their belt rank. Adults can attend unlimited designated classes. I understand that during the course of instruction, employees of the Gym and/or other Members or authorized persons will be engaged in a course of conduct requiring physical contact, and I give full consent to such contact as is required by the training. I authorize AK MARTIAL ARTS and FITNESS, Inc. permission to reproduce, publish, circulate, copyright or otherwise use any photographs and/or videotape of student taken at the Gym to promote the Gym and its events.

Authorization*

Yes, I agree to the terms and conditions listed on this web pageNo, I do not agree, therefore i can not attend the free week of classes