Warrior Spirit Martial Arts Academy,                              Application for Admission

 

Student Name Sex ---- Male Female Age   Birth Date   

 Height Weight   Address     City   

Zip Code   Telephone

School (if for Child)   Grade Level ---- 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th  Teacher

Responsible Party Name   

Physical Fitness	Self Control	Self Esteem
Coordination	Strength to say "NO"	Competition
Improve Grades	Greater Energy	Flexibility
Weight Control	Self Discipline	Respect for Others
Self Confidence	Meet New People	Recreation
Stress Management	Self Defense	Endurance

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How did you hear about us/come to our Website    

Have you ever studied before ---- Yes No         How long have you lived in the area     

Can you attend 2 Classes per week? ---- Yes No    Will you be living in the area for the next year?  ---- Yes No

Student or his Parents acknowledges the existence of the potential for personal injury in participating in a course of instruction in an a course of instruction in an activity such as Wu Shen Pai Kenpo and that he or she, in consideration of being admitted to Warrior Spirit Martial Arts Academy, is assuming this risk without liability to this school or its instructors, assigns, employees, etc. by executing this agreement and participating in this course of instruction