Trial Class Student Evaluation Form

What day would you like to do your trial class? Choose from below:

Student's Name:

First NameLast Name

Gender:

Student's Name:

First NameLast Name

Gender:

Student's Name:

First NameLast Name

Gender:

Parent/Guardian Information 1

Name:

First NameLast Name

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home Number:

Area CodePhone Number

Cell Number:

Area CodePhone Number

E-mail:

Are you a student at another Martial Arts school?

If yes, Name of school:

Any physical or mental health conditions that may affect you (or your child's) ability to participate in class?

If yes, please explain:

What are you interested in?

Any Martial Arts Experience?

If yes, what belt level is your child?

What do you (your child) look to gain from learning martial arts?

Why are you (your child) interested in martial arts?

How did you hear about us?

Referred by:

Waiver:

Martial arts is a contact sport. Members and guests use the school and equipment at their own risk. Kang's Mixed Martial Arts and staff are not responsible or liable for any damages from personal injuries, medical expenses or treatment, bodily injury, death, individual property, or any other loss, including but not limited to claims of negligence. Masters & instructors of Kang's MMA have been trained to teach Tae kwon Do, sparring, grappling and more. Masters and instructors will only teach with what they they were trained.

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Signature:

Date

MonthDayYear

Trial Class Student Waiver Form