MEMBERSHIP INTAKE FORM

top of page

Shao Long

Use tab to navigate through the menu items.

What is your choice of program?

Child Membership (8-12 yrs old)

Beginner Gongfu Only Membership (13+)

Adult Gongfu Only Membership (13+)

Taiji Only Membership (13+)

First Name of Student

Last Name of Student

Name of Parent (if under 18 - must be submitted by an Adult)

Phone

Email

Birthday of student

Why do you or your child want to learn Chinese Martial Arts?

Do you or your child have any medical ailments affecting intense physical activity?

How did you find out about our school?

Google

Facebook

Instagram

Yelp!

Family/Friend

Other

Self-defense - Seminars - Taiji - Kungfu - Qigong - Meditation - Lion Dancing

bottom of page