Class Registration Form

Class Registration Form

To book for a place in a Mantis Martial Arts class, please complete the form below.
Child's Name: *

First Name Last Name
Child's Birth Date: *

Month Day Year
If you would like to also enroll a sibling, please provide their name and age below:

0/300
Mini Mantis (ages 3-5) class you wish to enroll in:

Mini Mantis: Saturday at Little Pea, 10.30-11.15am (45 minutes)
Mantis Kids ages 6-14) class you wish to enroll in:

Mantis Kids: Saturday at LIttle Pea, 9.30-10.30am (60 minutes)
Private class:
Does your child(ren) have any martial arts training: *

No Less than 1 year 1-2 years Over 2 years
Please provide any medical or dietary restrictions your child(ren) have:
How did you hear about Mantis?: *
Family Information
Parent/Guardian's Name: *

First Name Last Name
Contact Phone Number: *

Area Code Phone Number
E-mail Address: *
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Emergency Contact Information
Emergency Contact Name: *

First Name Last Name
Emergency Contact Phone Number: *

Area Code Phone Number
Relationship to Student: *
By submitting and signing this form, parents or legal guardians agree that:

Liability Release: Parents or legal guardians of all students recognize and understand the risks of physical injury inherent to martial arts training and fully assume those risks. You hereby release Mantis Martial Arts for Kids, its affiliate venues/studios, event sponsors, employees and teachers from all liability, costs and judgements for injuries sustained, illnesses contracted or damages occured to any person or property while your child(ren) attend or participate in any martial arts camps, classes, workshops, or performances.

Medical Attention: In case of physical injury or medical emergency, the parents or legal guardians understand that Mantis Martial Arts for Kids will attempt to notify the person(s) you have named as your emergency contact(s) on this registration form. Should it be required, you hereby authorize Mantis Martial Arts for Kids to make arrangements to transport your child to the nearest medical treatment facility as necessary. All such transportation and medical treatment will be at your sole cost and expense.

Media Release: Mantis Martial Arts for Kids reserves the right to use photographs and videos taken during camps, classes, workshops, performances, or other affiliated events for the purposes of instruction, advertising and promoting our facility and programs. We will never tag or name any featured students. Parent or legal guardians who do not wish to comply with this policy must notify Mantis Martial Arts for Kids in writing prior to participation in our camps or classes.
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Class Registration Form

Family Information

Emergency Contact Information