Self Defense Registration

cLEMENT maRTIAL aRTS - sELF dEFENsE FOR WOMAN / Kids / Mixed Women & Men - REGISTRATION

Completing this form will express an interest and secure a spot in the Self Defense Classes Running from

Kids Monday 4:30pm - 6:00pm
Mixed Male & Female Tuesday 9:30am - 11:00am.
Women's Thursday 9:30am - 11:00am.

The cost is $20 Per 90 Minute Session with the First session being Free

You will need to Obtain 12oz Gloves ( Boxing Gloves) These can be otained through Rebel Sport, Counterpunch, Marketplace etc )

* Indicates required field

Full Name *

First

Last

Phone Number *

Email *

Class Options *

Monday Kid's: 4:30pm - 6:00pm Tuesday Mixed Male & Female: 9:30am - 11:00am Thursday Women's: 9:30am - 11:00am

Question? *

I acknowledge that participating in physical activity carries a risk and I accept all responsibility for that risk. *

I Agree

I have read and agreed to abide by Kumeu Gym's Code of Conduct *

I Agree

I will ensure that I bring all necessary equipment for my selected classes (Gloves) *

I Agree

Submit

Code of Conduct

cLEMENT maRTIAL aRTS - sELF dEFENsE FOR WOMAN / Kids / Mixed Women & Men - REGISTRATION

Members have access 24/7
Our Staffed Hours are:

contact number

Email

cLEMENT maRTIAL aRTS - sELF dEFENsE FOR WOMAN / Kids / Mixed Women & Men - REGISTRATION

Members have access 24/7Our Staffed Hours are:

contact number

Email​

Members have access 24/7
Our Staffed Hours are:

Email