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If you are ready to start down your path to Black Belt, please fill out this form (once per student) and click the “Submit” button at the bottom to reserve your spot in our next available session. Please note that your enrollment is not complete until you have submitted your enrollment fee (available at this link).

Please read our Waiver of Liability.

If you enroll at least two weeks before the start of the session, $10 will be credited towards your first tuition payment. If the class you are interested in is operating on a waitlist, your enrollment fee will reserve your position on the list. If no spot opens up on the waitlist, your enrollment fee will be refunded.

Student Name

First Name

Last Name

Class Choice

Eagledove Video Library Access (non-Panthers only)

Optional add-on provides access to supplemental video tutorials; not available to Panther Program students

Grade (if in school)

Student Birthdate

YYYY

Gender

Height (for uniform)

Weight (for uniform)

Clothing size (for uniform)

Build Description (for uniform)

e.g. average, slim, athletic, stocky

Financially Responsible Party Name (if different from Student)

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone (calls and texts)

(###)

###

####

Payment Plan

For split payments, the second payment is due 2 weeks after the start of the session.

Additional comments (health concerns, etc.)

How did you hear about us?

Waiver of Liability

I have read the Waiver of Liability and I agree to its terms

Refund Policy

Once enrollment in a session is confirmed, all payments and fees are non-refundable. In the event of a documented extended illness or injury where make-up classes are not available, credit for missed classes will be applied to a future session.

I agree

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Eagledove Martial Arts