Registration does not automatically guaranty enrollment.  Classes fill up on a first come first serve basis.  Spots are only
held once payment is received.  Fill out a separate registration for each student.
Student's First Name
Student's Last Name
Student Birthday
MM/DD/YYYY
Parent/Guardian Name
(if applicable)
Phone number
Email address
Session  (June 18 - September 1)
Choose one day/time from list below
Kids  (Ages 4-6) - New Students & Returning White/Orange/Yellow Belts
Mon/Wed 6:00-6:30pm
Tuesdays 5:20-6:00pm
O
Tuesdays 6:00-6:40pm (Class is FULL)
Kids  (Ages 7-14) - New Students & Returning White/Orange/Yellow Belts
O
Mon/Wed 6:30-7:00pm (Class is FULL)
Tuesdays 6:40-7:20pm
Returning Students ONLY
Mon/Wed 5:30-6:00pm   (Black Belts)
Mon/Wed 7:00-7:30pm   (Camo/Green/Purple)
Mon/Wed 7:30-8:00pm   (Blue - Rec Black)
Adults/Teens  (Ages 14+)
Taekwondo - Tuesdays 8:00-8:40pm
Krav Maga   - Mon/Wed  8:00-8:40pm
Martial Arts Wellness Center • Burlington, Wisconsin • (262) 758-3378
Email Us • http://www.BlackBeltAcademyInfo.com/
Martial Arts Wellness Center, All Rights Reserved.
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