RegistrationPay Monthly Fee Registration Form Children InformationName *SizeGenderM/FMaleFemaleDate of Birth *SchoolFeesEmergency ContactName *Relation *Phone *Parent/Guardian InformationFull Name *Street Address *Company *Job/Occupation *Work PhoneCell PhonePayment Agreement *Please pay monthly fee of $100 every month on time due on the 1st of the month or a late fee of $20 will be applied. Registration fee of $250 assumes full participation in the weekly program. Students will receive a free uniform and belt upon paid registration fee, The responsible party's signature assumes full responsibilities for paying the monthly fee in a full and timely matter. You may cancel the student's enrollment by contacting Vashon Robinson, By signing this document, you agree to the conditions of the fee policy release agreement I understand that the Martial Arts program are high impact and involve physical contact Therefore, I release the martial arts instructions and legal responsibilities for accidents and injuries that occurred while training in martial arts. Photo release, I agree that the martial art class may use photos and videos footage of the above named student for publicity purposes in all forms.Parent/Guardian Signature *Parent/Guardian Email *Date *Registration Fee$Submit Application Monthly Fee Payment Children InformationName *ID/RefrenceNote/MessageFee *Parent/Guardian Name *Parent/Guardian Email *Total Due$Submit Fee
