GV Kenpo Family Karate Registration Student Name * Student Name First First Last Last Age * Nickname (if any) Phone Number * Address * City * Zip * Email * May we add you to our email list? You may opt out at any time. * Yes No Occupation/School Emergency Contact Name * Relationship to Participant * Emergency Phone * Do you have any previous martial arts experience? If so, please describe style and rank. How did you find out about us? Why are you interested in working out with us? What are your short term goals? What are your long term goals? Do you have any health issues that the instructors should be aware of? Is there anything else the instructors should know about you? If you are human, leave this field blank. SUBMIT By clicking SUBMIT you agree to our terms and conditions. View them HERE. View our COVID-19 policy HERE.