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American Tiger Karate Academy



* Required Information

Please Read Waiver of Liability Web Page Before Filling Out Online Registration Form.
*Students Last Name
*First Name
*Middle Initial
*Street Address
*City
*State
*Zip Code
*Home Phone
*E-Mail Address
*Gender
*Students DOB

Only applies if student is under the age of 18
Partents Full Name, Last, First, MI
Referred By:
*Name of class for which you are registering

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Waiver of Liability Section

Located Below the Registration Tab Waiver of Libility Section
*I have read and understand the Waiver of Liability Section (Print Name, & Date)