ROYAL DRAGON MARTIAL ARTS STUDENT ENROLLMENT FORM

 

STUDENT NAME_______________________________________________ Date______________

(IF CHILD) PARENTS NAME(s)____________________________________________________

ADDRESS_____________________________________

CITY________________________ZIP_____________

PHONE__________________ Wk__________________

AGE_____ DATE OF BIRTH________________


REASON FOR JOINING MARTIAL ARTS?

(Check All That Apply)

__Self-Defense __Discipline

__Fitness/Aerobics __Stress Relief

__Tournament Competition __ Weight Control

__ Job Requirement (bodyguard, law enforcement, etc.)

__Continue Previous Martial Arts Training

If you have trained in the martial arts before, please fill out the next section

Style____________________ Instructors Name________________________

School Name _______________________

Phone___________________ Rank Achieved________________________

Years of Training _________________

Date of last class_________________

How did you hear about our school?

__Brandon News __Phonebook __Walk By __Drive By

__ Direct Mail __Recommended by_______________ Other__________________

Liability Waiver

I understand that participating in any organized sport carries certain risk of injury. I understand that by following all school rules, wearing all appropriate protective equipment, and warming up prior to class reduces but does not eliminate the possibility of injury. I agree not to hold the instructors, the school, or my fellow students responsible or liable in case of injury.

 

X______________________________ Date___________ 

 

(Parent of Guardian for those under 18)___________________________________

 

TUITION PAYMENTS

There are two ways you can make your monthly tuition payment. With each plan you need to fill out one simple form . Please select a payment plan.

1) Automated Payment through EZ-PAY (no monthly service charge), each month your bank makes your payment for you with a paperless check transaction, you may use a checking or savings account. This plan saves time & money, no postage, no late fees, no service charges. This is the preferred method of paying tuition. 90% of our students use this method.

2) Coupon Book Payment ( includes a $3.90 monthly service charge, plus $10 late fee). A coupon book is mailed to your home, it is your responsibility to mail in your payments each month. This plan costs you an additional $50.76 annually in service charges and postage costs (not including possible late fees in the event you are late). After three late payments, the account must be switched to the EZ-Pay automated payment.

There are no contracts with either payment, you pay month to month.

I select; (Please Check One)

___ AUTOMATED PAYMENT (FREE)

__ COUPON MAIL-IN PAYMENTS ($50.76 in annual service charges)

If you would like more information on our payment plans, please ask the attending instructor. Thank you.

 

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