Jeon Eui Taekwondo Branch – New Term Registration

Membership | Branch Registration

Registration for class at the branch in Marine Drive

Date: Sundays, April 2, 2023 to June 25, 2023 (10 Lessons)
*No Class on April 9, April 23 and May 21, 2023
Time: 3:45 PM - 4:40 PM (White to Yellow-Green Belts) / 4:45 PM - 5:40 PM (Green Belts and Up)
Registration Fee: $144 plus GST (Please note that the registration fee includes credit from the cancelled class on February 26, 2023)

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

Consent for Bank Withdrawal (Only for members who have a bank account on file)

Pay Online

Bank Withdrawal Authorization
I/We hereby authorize Jeon Eui Taekwondo to direct my Financial Institution to debit my/our bank account, on file for $151.20 for the tuition fees for the term from April 2 to June 25, 2022 at Marine Drive Branch.
If any payment is returned by the Bank for any reason, I/we will be responsible for Non-Sufficient Funds (NSF) and/or administration charges.
I/We, the undersigned, have read, understood, and agree to the terms and conditions of this agreement.

Signature

Clear

Date

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%)

Total