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KYOKUSHIN KARATE CLASS - REGISTRATION
START DATE: SEPTEMBER 12, 2022
AGE: 6 YR OLD AND UP
MONDAY, WEDNESDAY & FRIDAY: 6:00 PM – 7:30 PM
ADDRESS: 14120 NEWBROOK DR, CHANTILLY, VA 20151
CONTACT:
info@atillama.com
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FISRT AND LAST NAME
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SIBLING FIRST AND LAST NAME (OPTIONAL)
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DATE OF BIRTH
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DD
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YYYY
SIBLING DATE OF BIRTH (OPTIONAL)
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DD
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YYYY
PARENT NAME
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PARENT EMAIL
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PHONE NUMBER
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MARTIAL ARTS BACKGROUND
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HOW DID YOU HEAR ABOUT US
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FRIEND
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MONTHLY CHARGE - $200 ($350 FOR 2 KIDS)
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