KRAV MAGA
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.
Session  (September 10 - December 1) *
IMPORTANT:
All students must be at least 14 years old
Student's First Name
Student's Last Name
Student Birthday
MM/DD/YYYY
Parent/Guardian Name
(if student under 18 years old)
Phone number
Email address
Krav Maga   - Mon/Wed  8:15-8:55pm
* - No classes on 11/26
KRAV HOME PAGE          OTHER PROGRAMS
Martial Arts Wellness Center • Burlington, Wisconsin • (262) 758-3378
Email Us http://www.BlackBeltAcademyInfo.com/krav.html