Prime Taekwondo Registration

Complete the application below. Your requested class times are preferences; our team will confirm the final schedule. No payment is processed by this form.

STUDENT

Student Information

First name * Last name * Date of birth *

YYYY/MM/DD Gender * Home address * City * Province * Postal code * Medical conditions / allergies / important notes

FAMILY & CONTACT

Parent / Guardian or Account Holder

First name *Last name * Cell phone *Email * Parent / Guardian 2 first nameParent / Guardian 2 last name Parent / Guardian 2 phoneParent / Guardian 2 email Emergency contact name *Emergency contact phone * How did you hear about Prime Taekwondo?

MEMBERSHIP

Location, Program & Membership

Dojang * Program * Classes per week *2 classes per week is the default selection. Membership type * Requested start date *

YYYY/MM/DD Uniform *

White uniform · $70.00 incl. GSTRequired for every new registration.

Have a special Prime code? (optional)

Special Prime code

CLASS PREFERENCE

Requested Class Days / Times

Choose the number of requested classes that matches your membership. These are preferences only; the final Staff Roster assignment is confirmed after registration.

Choose a dojang and program to see current class choices. Your requested start date will re-check the schedule.

Other requested class days / times

AGREEMENT

Additional Provisions, Terms & Waiver

The agreement below is the membership terms currently presented for electronic signature.

Pricing clarification for this online application: tuition is shown before GST; the posted Registration Fee of $35.00 and Uniform price of $70.00 are GST-included totals. The legal agreement text below is preserved as written from the membership application.

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I have carefully read and understand the Additional Provisions, Terms and Conditions, including the Waiver and Release, and agree to be bound by them. *