Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

What are your primary goals for private lessons?

(Check all that apply)

Self-defense

Fitness & conditioning

Stress relief & mindfulness

Traditional martial arts training

Parent-child bonding (learning with a child or as a family activity)

Injury rehabilitation (gentle training after an injury)

Fun & recreation

Other (not listed)

Parent 1 (if under 18)

First Name

Last Name

Parent 2 (if under 18)

First Name

Last Name

Emergency Contact

First Name

Last Name

Emergency Phone

(###)

###

####

Photo Consent and Usage Agreement

Weekly Report Photos: At Kyle's Karate, we may take photographs during classes. These photos may be included in weekly reports, which are emailed exclusively to the registered participant (if an adult) or to the parent/guardian (if a child is enrolled). Promotional Photos Consent (Opt-In Available): By registering for Kyle’s Karate, you grant permission for the use of class photos in weekly reports. If you would like to grant additional permission for these photos to be used for promotional, advertising, and marketing purposes in a respectful and positive manner, please select the "Opt-In" box below. Promotional use may include our website, social media, and printed flyers to showcase our programs. Opting in is entirely voluntary and will not affect participation in classes.

Opt-In

Registration and Injury Release *

By clicking "I Accept", I confirm that I am over the age of 18 and have read, understood, and agreed to the injury release below. Injury Release: Participation in sports involves inherent risks, and while many can be minimized, not all risks can be eliminated. I acknowledge that I (or my child, if enrolling a minor) am voluntarily participating in the martial arts program at Kyle's Karate, which includes physical activities such as fitness training and martial arts instruction. I affirm that I (or my child) am in good physical condition and have no known disabilities or conditions that would prevent or limit participation. I understand that enrollment is voluntary and not required by Kyle's Karate. In consideration of participation, I release Kyle's Karate and its instructors from any claims, demands, or liability for injuries, illnesses, or other conditions, whether known or unknown, that may arise now or in the future as a result of participation in this program.

I Accept