Enrollment Form

For a limited time, Capital Karate is offering kids martial arts classes for two weeks at $29. This includes a one-to-one session with Sensei Miko, a student uniform and a belt. No registration fee.

Student Information

First Name

Last Name

Class

Parent Information

First Name

Last Name

Email

Phone Number

Country

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Notes

If you have any additional information you would like to share, please use the text box below.

Enrollment Form

Capital Karate With Sensei Miko Peled