First Name:  Last Name:

Date of Birth:   Current Belt or Rank:

Address Street: Apt #:

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Telephone (incl. area code):    E-Mail Address:

First Name: Last Name:

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Tiny Tiger Test - Wednesday December 11th, 2024
at Manna's Martial Arts
Register on or before December 5th: $40
Register after Dec. 5th: $60 (incl. late fee)

By clicking on the “submit” button on this form, I submit this application for promotion in Manna’s Martial Arts and accept any grade or belt rank rendered by this system with complete satisfaction, neither contesting nor demanding a higher grade or belt rank.

Participant Parent/Guardian of applicant as named above  Date:

Please fill in ALL required fields indicated with a red star (), above date format mm/dd/yyyy.