Maine Traditional Karate:

Orrington Dojo Little Samurai Registration

Please provide the following information to enroll as a student in the dojo. This registration form is for students enrolling in the Orrington Friday Little Samurai (Ages 4-7yrs old) class. Upon submission you should receive an email with your student ID and login information.

We will send your student's bill via our PayPal invoicing service to establish payments within the next week. We look forward to training with you!

 

First name:
Last name
E-mail:
Birth Date:
Phone #:
Street Address:
City:
State:
Zip Code:
Medical Conditions:
Emergency Contact #:
Emergency Contact Name: