Hauth’s Family Taekwondo Center   est. 1988       Windsor  CA.

Enrollment Application

 

Applicant’s Name: ________________________________________________

Parent’s Name (If Minor): __________________________________________

Mailing Address:  ______________________City __________ Zip _________

Telephone # _____________  2nd # ____________  Birthday ___________

 

Email Address: _____________________  5 Weeks _____ 10 Weeks _____

 

Any previous Martial Arts Training?  ______  If yes,  please indicate which style of Martial Art,  what Belt Rank you earned and are you actively training in that style. _______________________________________________________

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Why do you wish to Learn Taekwondo?

1. Self Defense                 _______

2. Physical Fitness           _______

3. Self Discipline              _______

4. Family Activity             _______

5. Self Confidence           _______

6. Idle Curiosity                _______

7. Other ________________________________________________________

 

Does the Applicant have any physical or learning limitations that the Instructors should be aware.  (confidential) ______________________________________

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How did you hear about us?

 

Signage _____  Flyer or Ad _____ Walk by _____ Referral _____ by ________

 

 

 

Signature __________________________    Date __________

Signature - Parent or Guardian in Applicant is under 18 yrs. Old ________________________