new student questionaire.

A Customized Learning Plan Begins Here.

Please take a few minutes to answer the following questions, click the acknowledgments. This basic info will allow me to serve you more effectively. Your information will not be shared.

First Name

Last Name

Address

Phone

Date of Birth:

Gender:

Male

Female

Parent/Guardian Signature for students under 18 years of age.

Do you have any special needs, physical limitations/conditions that may affect your participation? If so, please let me know so we can make adjustments as needed.

Do you have any previous martial arts, self defense, meditation, yoga, fitness training? If so, please share with me what, how long, where, are you currently training? Have we ever worked together before?

What are your goals and objectives for training? What do you want to achieve?

How did you learn about us?

Google

Yahoo

Twitter

Facebook

Other online/print source:

Referral Source:

Please read, click to acknowledge the following:

I understand it is recommended one obtain physician approval before undertaking any new exercise regimen.

I have been advised to study and adhere to the principle of healthy training methods, and to start out slow with new exercises, focusing on developing proper form, increasing intensity over time, in keeping with my current level of fitnes and bodily constitution, making commonsense adjustments wherever needed.

The self defense methods taught in this course are for informational purposes, are inherently dangerous, can/will do great bodily harm. Always practice in a safe, positive, responsible fashion. Christopher and Robyn Scafone, Infinite Path Martial Arts assumes no responsibility for any injury/claim arising out of the use/misuse of the methods taught in this course.

Date

Thank you for sharing that helpful information. I'll be in touch soon.
Have a blessed day!

Begin your customized learning plan today!

Like, share, subscribe, enroll.

Unlock Your Potential, Workouts That Work For You.