Introductory Trial Registration Form

Once this form is completed please email info@prodigymartialarts.ca when you would like to begin your trial.

The One Week Trial includes One Week of UNLIMITED Classes and a FREE Uniform.

Please completely fill out each form for each participant that is registering for the One Week Trial.

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

Which class(es) are you joining? *

MINI NINJA KARATE

KIDS KARATE

ADULT KARATE

You're enrolling at:

MISSISSAUGA DOJO

Enter payment details for this plan

One Week Trial - UNLIMITED CLASSES

$28.24 FOR 6 PASSES

Please read and sign the following agreements

INTRODUCTORY TRIAL - Waiver & Liability Agreement

Introductory Trial Registration Form

Personal Information

Emergency Contact Information

Which class(es) are you joining? *

You're enrolling at:

Enter payment details for this plan

One Week Trial - UNLIMITED CLASSES

Please read and sign the following agreements

Success!

Hmm...

Introductory Trial Registration Form

Personal Information

Emergency Contact Information

Which class(es) are you joining? *

You're enrolling at:

Enter payment details for this plan

One Week Trial - UNLIMITED CLASSES

Please read and sign the following agreements

Which contact methods do you consent to?

Success!

Hmm...