WESTERN LOTUS

ATHLETICS & MARTIAL CLUB

5925 Karl Rd - 614 260 1374

New student application

Name

First Name

Last Name

Phone

(###)

###

####

Do you have any previous Martial Arts Experience?

If “Yes”, what style(s) & how long

What do you expect to gain from training Martial Arts?

How much would you expect to pay for Martial Arts training?

Is there anyone against you training Martial Arts

Are you familiar with Wing Chun/Wing Tsun

If so, what?

Question/comments