pankration@shaw.ca

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Self Defense Fitness Sport
  Personal Development  

Contact and Enrollment

Inquiry
If you provide us with some information on your interests, goals & desired benefits, we will be able to help to start you on your path to results and benefits.

Please fill in all fields.
We do not give out info to 3rd party.

Select which program(s) you are interested in:
1. Adult Program
-Pankration-all Powers Combat
-Muay Thai Kickboxing
-Cardio Muay Thai Kickboxing
2. Juniors/Children's Program
3. Cardio Muay Thai Kickboxing/
Fitness Kickboxing


First Name:
Last Name:
Home Address:
Phone Number:
Email Address:
Birthdate:
Occupation:

Why do you want to study Martial Arts?
List 3 Benefits in order of importance to you.
1st If other, please specify
2nd If other, please specify
3rd If other, please specify


Have you taken a Martial Arts Program in the past?
No
Yes When?
How long?
Have you ever competed in Martial Arts?
      No 
      Yes   Details


How did you find out about our website?


Please use this space for any questions or comments you wish to send us.

 

Located at:

2916 Graveley Street , Vancouver , BC V5K 3K3

Phone (604)255-5344

 

© 2009 - t_l@live.ca