Martial Arts Wellness Center • Burlington, Wisconsin • (262) 758-3378
Email Us • http://www.BlackBeltAcademyInfo.com/
Martial Arts Wellness Center, All Rights Reserved.
Spring Session Registration
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
Spring Session  (March 8 - May 29) *
* See Schedule page for special dates
Choose one day/time from list below.  Minimum of 3 students needed to conduct class for session.
Kids  (Ages 4-6) - New Students & Returning White/Orange/Yellow Belts
Mon/Wed 5:30-6:00pm (2 days per week)
Tuesdays 5:30-6:10pm (1 day per week)
Kids  (Ages 7-14) - New Students & Returning White/Orange/Yellow Belts
Mon/Wed 6:10-6:40pm (2 days per week)
Tuesdays 6:20-7:00pm (1 day per week)
Middle/High Ranks - Returning Students ONLY
Mon/Wed 6:50-7:20pm   (Camo/Green/Purple) - 2 days per week
Tuesdays 7:10-7:50pm   (Camo/Green/Purple) - 1 day per week
Mon/Wed 7:30pm   (Blue - Rec Black)
Decided Black Belts
Black Belts (Taekwondo) - Tuesdays 8:00pm & Wednesday-8:10pm
Adults/Teens  (Ages 14+)
Krav Maga  - Mondays 8:10pm & Wednesdays 8:50pm
IMPORTANT NOTES:
The health and well-being of our students and their families is our top priority.
- Classes can be taken In-Person or Online
- Class sizes are limited to ensure social distancing
- Temperatures are taken upon entry to the school
- Masks must be worn at all times while in the school (students/parents/instructors)
- Instructors wipe down all equipment and surfaces between classes
- Hand sanitizer and anti-bacterial soap is available