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After School Martial Arts Registration

If you are applying for more than one child, you must fill out a separate form for each child.
Child's Name (*)
Enter child's name
Age
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Date of Birth
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Gender
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Parent Name (*)
Please provide parent name
Email (*)
Please provide valid email
Street Address (*)
Please enter street address
City (*)
Please enter city
State (*)
Please enter state
Zip (*)
Enter zip code
Day Phone
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Evening Phone
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Cell Phone
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1. Please check each area that you feel is particularly important for your child, or that you would like to see improvement in. (Check as many as apply.)














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Of the boxes you checked above, which is the ONE area that stands out as most important to you right now?
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2. Do you live in Upper Dublin?
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If not, where?
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Do you plan to stay in the area for the foreseeable future?
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3. Are you applying with anyone else?
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If so, who?
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4. Does your child have any previous martial arts experience?
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If yes, why did your child stop training?
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What did you like about the classes?
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What did you dislike?
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5. If married, or if both parents share custody of applicant, are both parents supportive of your child training in martial arts?
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If not, please explain the circumstances.
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6. Has your child been in an After-School Program in the past?
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If yes, what did you like about that program, and what were you disappointed in?
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7. How did you hear about Competitive Edge?
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If Referral, by whom:
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If other, please specify:
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8. Does your child have any Medical Conditions, special challenges or other limitations we should be aware of?
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If yes, please describe in detail.
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9. What would your child's START DATE be in Competitive Edge's After School Program?
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Program Begins: September 5, 2017 ~ Program Ends: June 15, 2017
10. What school would we be picking your child up from?
School District: (*)
Please enter school district
School Name: (*)
Please enter school name
11. How many days a week are you enrolling for?
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Which days of the week?





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12. FREE Introductory Tours will be at 6:15 Monday through Thursday.
Please specify which day you would like to schedule your tour:




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If you are applying for more than one child, you must fill out a separate form for each child.
  
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