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
Fall Session  (September 10 - December 1)
Choose one day/time from list below
Kids  (Ages 4-6) - New Students & Returning White/Orange/Yellow Belts
Mon/Wed 6:15-6:45pm
O
Tuesdays 6:15-6:55pm  (CLOSED - CLASS FULL)
Kids  (Ages 7-14) - New Students & Returning White/Orange/Yellow Belts
Mon/Wed 6:45-7:15pm
O
Tuesdays 6:55-7:35pm (CLOSED - CLASS FULL)
Returning Students ONLY
Mon/Wed 7:15-7:45pm   (Camo/Green/Purple)
Mon/Wed 7:45-8:15pm   (Blue - Rec Black)
Tue 7:35-8:15pm   (Black Belts)
Adults/Teens  (Ages 14+)
Taekwondo - Tuesdays 8:15-8:55pm
Krav Maga   - Mon/Wed  8:15-8:55pm
Martial Arts Wellness Center • Burlington, Wisconsin • (262) 758-3378
Email Ushttp://www.BlackBeltAcademyInfo.com/
Martial Arts Wellness Center, All Rights Reserved.
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