Student Application

Student Application
Address *
For 18 Yrs. and Younger
What Benefits Are You Most Interested In Obtaining By Participating/Training In Our Program?
How Did You Hear About Us? *
Any Previous Martial Arts Training? *
Please list any physical defects, illnesses or conditions (such as asthma, epilepsy, high blood pressure, ADD, ADHD, autism, etc.
I agree there are NO physical conditions or illnesses which would render the applicant unable to participate in a strenuous physical activity, such as martial arts training.
Recognizing that the nature of this activity involves risk of personal injury, and with this knowledge, the applicant agrees to indemnify and hold harmless Encinitas Karate, Inc. and it's officers, instructors and staff from any and all liability and losses whatsoever arising from participation in this program.