Orland Shorin Ryu Registration

Registration

Hello and Welcome to the sign-up process

Signing up is a very easy, this form will guide you through it. Your Gi and your Federation membership are included in the prices listed below. A form needs to be completed for each student, so if there are multiple students from the same household, each one will need a separate contract filled out.

Thank you

Sensei

Student's Information:

First Name:	Last Name:	Date of Birth:	Email:
Address:	City:	State:	Phone:

Reason for Karate Training:

In numbered order, one being the most important, categorize each as to why you are interested in taking karate.

Physical Conditioning:	Better Concentration	Temper Control	Increase Athletic Ability
More Energy	Self Respect	Self Confidence	Weight Control
Self Defense	Better Mental Attitude	Self Discipline	Other (list)

Class Fees:

Please make a selection

1st Student/1 class per week ($60/month) 1st Student/2 classes per week ($75/month)

2nd Student/1 class per week ($45/month) 2nd Student/2 classes per week ($60/month)

**Student pre-paying for 6-months of training or more will receive a free Gi.

Special Notes/Comments:

Orland Shorin Ryu Karate and Kobudo Dojo has the right to refuse anyone admittance to any classes or functions.

By submitting this registration, you agree to follow the rules to the best of your abilities, and further agree that you will not abuse the lethal and non-lethal techniques that you will learn. You also agree to use what you learn for self-defense only, and that you will be loyal to this school and its instructors.

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Registration

Student's Information:

First Name:

Last Name:

Date of Birth:

Email:

Address:

City:

State:

Phone:

Reason for Karate Training:

Class Fees:

Please make a selection

Special Notes/Comments: