Registration Form Registration Form Date: * Student Name * Sex * Male Female Date of Birth * Street Address * City * State * Zip * Cell Phone * Email * Preferred means of contact: Contact Mode * Phone Text Email Emergency Contact Information: Last Name * First Name * Initial * Street Address * City * State * Zip * Home Phone * Cell Phone * Reason for interest in Tang Soo Do: * Any previous experience in the martial arts? Experience in marital arts * Yes No If yes, what style? * What level of rank did you obtain? * Why did you stop? * Do you have any physical or medical problems? physical or medical problems * Yes No If yes please explain * Safety is the most important aspect of our class. It is the responsibility of each student as well as instructors to uphold safety. Although safety is our number one priority, accidents and injuries may still occur. Please sign and date this document and return it to us before entering your first scheduled class. Read it very carefully before you sign. By signing this document, you agree to accept the risk involved in martial arts training and the following: In the event of an accident I hold myself responsible and not my instructors, fellow students, property owners or the staff of Karate USA. I will not hold anyone responsible, not now, or anytime in the future due to accidents or injuries incurred on or off this property, during training of any kind related to Karate USA or any affiliates of the Independent Tang Soo Do Association. Signature * If you are human, leave this field blank. Submit
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