February 1st 10:30am - 12pm

Join the women of Charleston Self Defense for a Women's Only Self Defense Seminar on February
1st, 2025 from 10:30am-12pm. Wear comfortable clothes and bring a friend! Ages 13-17 free with adult. May not be suitable for those under 12.

Personal Information

FIRST NAME *

LAST NAME *

UPLOAD PROFILE PHOTO

ADDRESS LINE 1

ADDRESS LINE 2

TOWN/CITY

POSTCODE

EMAIL ADDRESS (PRIMARY) *

EMAIL ADDRESS (SECONDARY)

GENDER

PHONE NUMBER

MOBILE NUMBER

DATE OF BIRTH

Emergency Contact Information

NAME

RELATIONSHIP

PHONE

MEDICAL / ALLERGY NOTES

You'll be joining:

CLINIC

You're enrolling at:

WEST ASHLEY

Please read and sign the following agreements

Charleston Self Defense Waiver

February 1st 10:30am - 12pm

Personal Information

Emergency Contact Information

You'll be joining:

You're enrolling at:

Please read and sign the following agreements

Success!

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February 1st 10:30am - 12pm

Personal Information

Emergency Contact Information

You'll be joining:

You're enrolling at:

Please read and sign the following agreements

Which contact methods do you consent to?

Success!

Hmm...