Mat Fee Payment

Thank you for visiting the dojo. We appreciate you supporting us with a mat fee. Please fill out the minimum information below and be sure to sign the liability waiver.

Visting the Dojo
Please arrive at the dojo at least 20 minutes early. Let the senior student or sensei know you are a visitor so they can introduce you to everyone. If you have any questions, please as before class starts.

Data Retention
We do not retain your payment information, however it will be electronically stored in a token by our Martialytics dojo software. If you want to visit again, your details will be retained.

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Personal Information

FIRST NAME *

LAST NAME *

UPLOAD PROFILE PHOTO

ADDRESS LINE 1

ADDRESS LINE 2

TOWN/CITY

POSTCODE

EMAIL ADDRESS (PRIMARY) *

EMAIL ADDRESS (SECONDARY)

GENDER

PHONE NUMBER

MOBILE NUMBER

DATE OF BIRTH

Emergency Contact Information

NAME

RELATIONSHIP

PHONE

MEDICAL / ALLERGY NOTES

You'll be joining:

AIKIDO

You're enrolling at:

KIMUSUBI AIKIDO ORLANDO DOJO

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Mat Fee (Per Visit)

$10.00 FOR 1 PASS

Please read and sign the following agreements

Release and Waiver of Liability

Mat Fee Payment

Personal Information

Emergency Contact Information

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You're enrolling at:

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Mat Fee (Per Visit)

Please read and sign the following agreements

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Mat Fee Payment

Personal Information

Emergency Contact Information

You'll be joining:

You're enrolling at:

Enter payment details for this plan

Mat Fee (Per Visit)

Please read and sign the following agreements

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