Registration form bring this to your first day of class or mail to the address below

In consideration of acceptance of this registration application, I hereby, for myself, my heirs, executors and administrators waive, release and forever discharge, any and all rights and claims for damages I the undersigned or as signing legal guardian (if under 18), agree that Tae Kwon Do is a contact sport/style of fighting art and do not hold Straits Area Tae Kwon Do Academy/Michigan Amateur Athletic Union/National Amateur Athletic Union/the building owner/Master Jamie Stelmaszek/Mark Johnson or any other students, responsible for injuries.

Send this form to or bring to first class.                                           Make Check or Money Order payable to Master Jamie Stelmaszek

Master Jamie Stelmaszek

E2173 St. Ignace Rd
St. Ignace MI 49781

Students Name______________________________       Age________   Rank_________
                                                   (printed)

Parent or Guardian Signature if under 18____________________________ _______________________________
                                                                                                           (sign)                                                                        (print)

Address______________________________City__________________Zip____________Phone______________

Payment:$20.00 Registration fee to start
Payment per class__  Payment per month__ (due first week of the month) Uniform__Size___ (not required to start)