Adult Application and Payment Adult Application Student's First Name* Student's Last Name Age Birth Date Shirt Size Street Address Street Address 2 City, State, Zip Home Phone Cell Phone Email Waiver* In consideration for my attendance and participation in this academy’s martial arts training, I, the student/ parent/ legal guardian, acknowledge the existence of certain inherent risks in this type of training and hereby agree to assume all risks. I furtherrelieve Nomad Aquatics and Fitness, M.A.T.I.,MATI Clubs,its management, assigned staff, and fellow students, from any liability resulting in personal injury or loss of personal belongings. I also hereby state that the student named above isphysically fit to take the prescribed course of instruction and do so of their own free will for an agreed upon fee. I understand there is no refund policy on any monies I will pay to this academy or representative of said academy. A parent or legal guardian signature is required if thestudent is under the age of 18. What specifically would you like to accomplish in our martial arts program?What is your fitness levelBeginnerIntermediateAdvancedOther Activities Medical Concerns PLEASE CHECK EACH ITEM OF IMPORTANCE TO YOUPhysical Fitness weight control/ exercise strength/ flexibility coordination stress release Self-Defense safety/ awareness always wanted to learn karate love the art form always wanted to earn a black belt Price Total $0.00 Credit Card Cardholder Name Card Details Agree* By clicking submit you are agreeing to the Terms and Conditions of our form.