KARATE REGISTRATION FORM

Please fill out and submit the following form and someone from Coppermine will reach out to you to secure payment.

Child's First Name: (required)

Child's Last Name: (required)

Child's Date of Birth: (required)

Parent's First Name: (required)

Parent's Last Name: (required)

Parent's Phone Number:

Parent's Email Address: (required)

Class of Interest: (required)

Upon receipt of your registration, we will reach out to you to secure payment.


Type the characters you see in the image below before you click Send
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