Fall 2019 Classes begin August 28th

2019

Please see the registration form for more information or to enroll.

DallasKenpo.com

Classes taught by Sensei Kory Helfman!

Children’s Kenpo Karate Classes at Mockingbird Elementary! Featuring 3-Steps to a Great Kid™ the

Martial Arts Character Development Program

Wednesdays New Students and White Belts w/ Black Stripe: 3:20p - 4p Yellow Belts and Yellow Belts w/ Black Stripe: 4:05p - 5p

Orange Belts & Higher: 5:05p - 5:55p

Fall 2019 Classes begin August 28th

2019

Please see the registration form for more information or to enroll.

DallasKenpo.com

Classes taught by Sensei Kory Helfman!

Children’s Kenpo Karate Classes at Mockingbird Elementary! Featuring 3-Steps to a Great Kid™ the

Martial Arts Character Development Program

Wednesdays New Students and White Belts w/ Black Stripe: 3:20p - 4p Yellow Belts and Yellow Belts w/ Black Stripe: 4:05p - 5p

Orange Belts & Higher: 5:05p - 5:55p

Our year-long after school program meets in the Fall and Spring semesters, culminating in our interschool “Kenpo Invitational Tournament” which will be held on February 22nd, 2020. Students will have the opportunity to compete against our other fifteen Chamberlain Studios programs in the Dallas area.

Classes meet on Wednesdays starting August 28th (which is a FREE Trial class day) and running through December 18th, 2019. There will be NO class on 11/27 (Thanksgiving). Promotion takes place at the end of the spring semester (sooner if your child is taking additional classes - pricing below).

Wednesdays: New Students and White Belts w/ Black Stripe: 3:20p - 4p Yellow Belts and Yellow Belts w/ Black Stripe: 4:05p - 5p

Orange Belts & Higher: 5:05p - 5:55p

Payment should be “In Full” for the semester, or via monthly AutoDraft. Visa, MC & Discover accepted. You may also pay over the phone by

calling our dojo office at: 214-351-5367.

Chamberlain Studios of Self Defense™ www.DallasKenpo.com Fax: 214-366-3916

Check One: Visa_____ MC ______ Disc _________ Card # :______________________________________ Exp: _____/______

OR : Check #: _______________

Student: _____________________________________________ Grade: _______ Birthdate:_______________ Date: ___________

Parents/Guardians: ________________________________________ Parent/Guardian signature: _____________________________

Address: _____________________________________________________________________________________ Zip: _____________

E-mail(s): ________________________________________________ Phone: __________________ Phone #2: ___________________

Health Issues: ___________________________________________________________________________________________________

Returning Student semester costs include: Fall Semester Tuition, Parent’s Day workout (1x per month at our main dojo locations), Make up classes at one of our main dojo locations if you miss an after school class day, & Spring Belt Promotion.

New Student semester costs include: Fall Semester tuition, Parent’s Day workout (1x per month at our main dojo locations), Make up classes at one of our main dojo locations if you miss a Mockingbird class day, Spring Belt Promotion, Custom Karate Uniform, new student handbook, & initial CSSD school patch. All handbooks, DVD’s & T-shirts (see below) that are purchased will need to be picked up from the Lakewood Dojo.

Payment is due with the registration form. Please place all checks and registration forms in an envelope and give to the instructor Sensei Kory Helfman. Siblings receive a 25% discount on Semester Tuition.

Fall Semester Pricing New Student Returning Student Sibling (25% off)

Fall Semester Tuition at Mockingbird

$281 1x per week at Mockingbird

$281 1x per week at Mockingbird

$211 1x per week at Mockingbird

Add Unlimited classes at CSSD - $65/month

____ (optional) ____ (optional) ____ (optional)

Registration $60 $20 $20

Custom Uniform - $35 $35 _____ (optional for returning students) _____ (optional for returning students)

Custom Dojo Patch - $10 ____ (optional) ____ (optional) ____ (optional)

Karate Patches (not custom) - $5 each ____ (optional) ____ (optional) ____ (optional)

Student Skills Manual (optional - by rank)

Circle Rank Level! - $25 Skills for Belt Color (circle) Y, O, P, B, G, B3, B2, B1

Skills for Belt Color (circle) Y, O, P, B, G, B3, B2, B1

Skills for Belt Color (circle) Y, O, P, B, G, B3, B2, B1

Student Skills DVD (optional - by rank)

Circle Rank Level! - $25 Skills for Belt Color (circle) Y, O, P, B, G, B3, B2, B1

Skills for Belt Color (circle) Y, O, P, B, G, B3, B2, B1

Skills for Belt Color (circle) Y, O, P, B, G, B3, B2, B1

Student History Manual - $25 ____ (optional) ____ (optional) ____ (optional)

Custom Karate T-shirt - $15 YS, YM, YL, AS, AM, AL

(optional-circle shirt size) YS, YM, YL, AS, AM, AL

(optional-circle shirt size) YS, YM, YL, AS, AM, AL

(optional-circle shirt size)

Semester Totals: $________ $________ $________

Check One: Payment in Full _______ Monthly Draft _____