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FAMILIES
Email/Text Familes
Lead File
STUDENTS
CLASSES
EVENTS
STORE
WEBSITE
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Mobile
Public Site
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New student Registration
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Family Name:
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Student Type
*
Student
Adult
Parent
First Name
*
Rankid
Last Name
*
Birth Date
Override Birth Date (Enroll student)
Last Promotion
Gender
Male
Female
Nick Name
Rank
Jr. Yellow 3rd Stripe
Godan
Green Belt
Hachidan
Ikkyu
Jr. Blue
Jr. Blue 1st Stripe
Jr. Blue 2nd Stripe
Jr. Blue 3rd Stripe
Jr. Blue 4th Stripe
Jr. Blue 5th Stripe
Jr. Blue 6th Stripe
Jr. Green
Jr. Green 1st Stripe
Jr. Green 2nd Stripe
Jr. Green 3rd Stripe
Jr. Green 4th Stripe
Jr. Green 5th Stripe
Jr. Green 6th Stripe
Jr. Orange
Jr. Orange 1st Stripe
Jr. Orange 2nd Stripe
Jr. Orange 3rd Stripe
Jr. Orange 4th Stripe
Jr. Orange 5th Stripe
Jr. Orange 6th Stripe
Jr. Purple
Jr. White
Jr. White 1st Stripe
Jr. White 2nd Stripe
Jr. White 4th Stripe
Jr. White 5th Stripe
Jr. White 6th Stripe
Jr. Yellow
Jr. Yellow 1st Stripe
Jr. Yellow 2nd Stripe
Jr. Yellow 4th Stripe
Jr. Yellow 5th Stripe
Jr. Yellow 6th Stripe
Jr.White 3rd Stripe
Kudan
Nidan
Nikyu
Orange Belt
Rokudan
Sandan
Sankyu
Shodan
Sichidan
TT Black Stripe
TT Blue Stripe
TT Brown Stripe
TT Green Stripe
TT Orange Stripe
TT Purple Stripe
TT White
TT Yellow Stripe
White Belt
Yellow Belt
Yodan
Cell #
Student Email
School
*
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Transportation
T-Shirt Size
Adult Large
Adult Medium
Adult Small
Adult X-Large
Adult XX-Large
Child Large
Child Medium
Child Small
Child X-Small
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Height
Skill Notes
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Weight
Location
KK1
NY
PENN
Primary Doctor
Immunization Notes
Start Date
Ageclass
Tiny Tiger
Peewee
Children
Youth
Adult
Card Address
*
Card Address line 2
Card City
*
Credit Card Payment
Card Expiration Month
*
Card Expiration Year
*
Card State
*
Card Zipcode
Student Image file
Name as it Appears on Card
*
Card Type
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Visa
Mastercard
Discover
America Express
Card Number
Comments
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