Emergency Contact Name & Phone Number
Previous Martial Arts Studied (including rank attained if any):
Your main reasons for studying martial arts (select all that apply):
Health & Fitness
Friendship &/or Community
Artistic Self Expression
Martial Arts Philosophy
History, Culture & Tradition
Strategy & Tactics
Please list any physical impairments, need for prescribed medication, health problems, medical conditions, mental health issues, and current or recurring injuries that may be aggrevated by martial arts training:
How did you hear about our school?
Internet Search Engine
Flyer or Poster
Other (Not Listed Above)
Thanks for submitting this pre-training questionnaire!
We hope you enjoy the training!