Whitecourt Taekwondo Student Registration Form
Please Fill in All Sections of the Form as Applicable.
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Email *
First Name (Student) *
Last Name *
Birthdate *
MM
/
DD
/
YYYY
PD Day Camp Attending (Select All Dates That Apply) *
Required
Parent/Guardian Name 1 *
Parent/Guardians Email (If different than above)
Guardian Phone 1 *
Medical Concerns or Allergies
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