Grasshoppers Martial Arts School: Trial Class Information Form 2022/2023 Season

Trial Class Information Form 2022/2023 Season

Please fill out this electronic trial form to register for 2 FREE trial classes. Note: We recommend the student to be a minmum of school age. If under school age, we recommend a parent try the class with them.

New Student Trials Start Monthly.

Venue

226 Waverley Road, Dartmouth NS B2X 2C4

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INFO:

Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and/or are not selectable.

Registration inquiries:
Master Phil Power
(902) 455-4853
www.grasshoppers.ca

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Registrant

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First name of student trying the class

Last name of student trying the class

Contact email

Contact Number (Cell Preferred)

Address

City

Is this registration form for a child or adult

Sex

Please specify identification

Date of Birth

Parent 1 Name

Parent 1 Cell Phone Number

Parent 1 Email Address

Parent 2 Name (If applicable)

Parent 2 Cell Phone (If applicable)

Parent 2 Email (If applicable)

Name of spouse or emergency contact

Cell phone number of spouse or emergency contact

Does the participant have ADD / ADHD / ODD / Autism etc?

Please Explain

Does the participant have any medical risks or serious allergies?

Please explain

If none, please indicate NONE

Have you tried martial arts before?

When would you like to try your 1st free trial class?

Remember that beginner classes are Monday and Thursdays only.

We try to book all new students on a Monday night if possible.

When would you like to try your 2nd free trial class?

Remember that beginner classes are Monday and Thursdays only.

We try to book all new students on a Monday night if possible.

How did you hear about us? (can select multiple)

Please select all that apply

Live in community
Recommended by friend
Online / Website
Social Media
Signage on building
Billboard

Terms

A qualified Instructor, Assistant Instructor, or Junior Instructor conducts all classes. Classes are supervised, but sometimes are more difficult for certain individuals. Please consult your doctor before starting any classes. After consulting your physician, if at any time you feel shortness of breath, pain, or discomfort, please feel free to step out of class and consult a physician or instructor. Upon signing this I understand and agree to waive, release, and forever discharge any and all rights and claims for damages which may occur against Grasshoppers Martial Arts Its directors, and / or all persons associated with Grasshoppers Martial Arts. I understand that TaeKwonDo is a potentially lethal martial art, I will not use my martial arts training without just cause.

Check this box to indicate that you have read and agree to all of the above terms & conditions

Electronic Signature