North Shore Karate Center Registration Form
Please fill out all of the information on the registration form and click the Submit button.
Cost for each ten-class session: $595

 

Student's Name

Parent's Name  

Address           

City/Zip           

E-mail             

Home Tel.          Work Tel.   Cell Phone

Student's Date of Birth 

Spring Session: Beginning Monday, March 29, 2010, 4:30 PM

Spring Session: Beginning Monday, March 29, 2010, 5:30 PM

Spring Session: Beginning Monday, March 29,  2010, 6:30 PM

Spring Session: Beginning Wednesday, March 31, 2010, 5:30 PM

Spring Session: Beginning Wednesday, March 31, 2010, 6:30 PM

 

Visa/Master Card Number    Exp. Date

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