ASKA
American Shotokan Karate Academy
Registration form
Student's name:
Your email address:
Student's address:
Your phone number:
Did you ever practice martial arts before? Yes or no?   If so what style, where, and when? How long
and what's your rank? You will have to provide us proof of you rank I.E. Promotion Certificate.  
Comments:
Student's Parent name
if under 18yrs old
Student's parent
address if different:
Your phone number:
Cell phone number:
IS THERE ANY PHYSICAL CONDITION, WHICH PRECLUDES YOUR CHILD, OR YOURSELF AS A
STUDENT FROM RUNNING, JUMPING, BENDING, SITTING, WALKING OR HAVE A RESPIRATORY
PROBLEM, HEART PROBLEM, SEIZURES, ASTHMA, VISION PROBLEM, OR ALLERGIES? ARE YOU
TAKING ANY MEDICATIONS? PLEASE STATE: YES OR, NO? If yes please use comment box below.
Comments:
ASSUMPTION OF RISK AGREEMENT AND RELEASE
(READ BEFORE SIGNING)
The undersigned assumes all responsibility for and all the risk of damages or injury that may occur
to the undersigned as a student in the AMERICAN SHOTOKAN KARATE ACADEMY, location of
competition (referred to in this assumption of risk agreement and release as "Dojo") or
demonstration site, while attending classes, participating in exercises or using karate equipment or
facilities or following karate course instruction in or out of this organization or other Karate course
instruction, competition and/or demonstration. In consideration of being accepted as a student in this
organization , the undersigned hereby releases and discharges AMERICAN SHOTOKAN KARATE
ACADEMY, THE CENTRAL TEXAS SCHOOL OF PERFORMING ARTS, and all associated Dojos
(schools), its and their owners, employers and agents from all claims, demands, rights of causes of
action, present or future, whether known, anticipated, and resulting from or arising out of, or incident
to, the undersigned's use (or intended use) of a Dojo or karate course instruction, competition
and/or demonstration location, or facilities and equipment in such place or as a result of, incident to,
engaging in karate course exercises or otherwise following karate course instructors anywhere.

I have read and understand and will sign in person the foregoing assumption of risk agreement and
release upon consideration for enrollment to the American Shotokan Karate Academy when I come
to class.
Print full name of person over 18yrs
old in box if you read and understand
ARA release
Please note that Payment of registration and Monthly fees are non-refundable and have to
be pay at the same time you submit this online form. A hard copy will also have to be
signed upon approval of new student enrollment.
A Great Place to Learn Martial Arts
Annual Registration Fee $25.00
Monthly Fee $65.00
Total amount = $80.00




It's just too easy,
Thank you!
Classes 3 times a week
12 times a month for only
$55.00 a month.
Pick the plan that's right for you or your family.
Remember there is no CONTRACTS or AGREEMENTS to sign!
We have your best interest at HEART!
No one can beat our rates or quality of Instruction;
in The Central Texas Ares.
Our prices are already discounted for you,
"Because we care, and we take what we do to
HEART"!
Individual Student
Annual Registration Fee
is $25.00
Thank You!
Family
Annual Registration Fee
is $35.00
Thank You!

Pay your Annual Registration Fee here.
TOO Easy!


Click Button to pay
Monthly fee $65.00



Thank you!


Click Button to pay
Ting Tiger monthly fee
or family discount fee
only


Thank you!
Family discount is available: $65.00 for the first family
member and $55.00 for any additional members.