Booking

Please provide the following information to enroll as a student in the dojo. This registration form is for students enrolling in the Corinna Thursday 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:

Mobile #:

Street Address:

City:

State:

Zip Code:

Emergency Contact Name:

Emergency Contact #:

Medical Conditions:

I have read and accept the Release and Waiver of Liability and Indemnity Agreement and agree to the terms of enrollment

Maine Traditional Karate:

Corinna Dojo Student Registration