Branch Registration – Jeon Eui Taekwondo

Membership | Branch Registration

Membership Information

First Name *

First

Last Name *

Last

Date of Birth

Age

Gender

Male

Female

Address *

Address

Street Address

Apt./Building/Suite #

City

State/Province

Zip/Postal

Country

Email Address *

Phone

Scheduled Lessons

Payment Method

Pay Online

Pay by Cheque (Only before early registration ends)

Emergency Contact Information

Emergency Contact Name

First

Last

Relationship to Member Relationship to Member

Emergency Contact Phone Number

Membership Policy

Please note that there is a no refund policy after you have submitted your registration. Spots for the class are limited and registration is done by a first come first serve basis. Registration is confirmed upon submission of your online registration form.

Payment Total

Subtotal

GST (5%)

Online Processing Fees (3%)

Total

Membership Information

Emergency Contact Information

Membership Policy

Payment Total

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