Zoom Class Family Signup

Disclaimer - Tuition and membership fees are NON-REFUNDABLE.

Billing Option*
- Month to Month
- Recurring Monthly Subscription
- Single Class (JKA Member)
- Single Class (Non-Member)
Name of First Student*
Age of First Student*
Present Rank of First Student*
Name of Second Student*
Age of Second Student*
Present Rank of Second Student*
Name of Third Student
Age of Third Student
Present Rank of Third Student
Are You New to JKA Karate of Arizona?*
- Yes (Two Students)
- Yes (Three Students)
- No
New students are required to pay a one-time $20 registration fee.
Dojo You Train At*
Instructor Name*
Billing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Credit Card
Card Details
Cardholder Name
Coupon (Case Sensitive)
Subtotal
Discount
Total
$0.00
Name
This field is for validation purposes and should be left unchanged.