Introductory Program Laverton - Samurai Karate Australia Classes Academy - Martial Arts

ONLINE REGISTRATION – SPECIAL LAVERTON DOJO

Uniform Value ($65)

Classes Available For All Ages From 4yrs – Adults.

3 Easy Steps To Get Registered

Step 1 – Choose your program
Step 2 – Enter your details
Step 3 – Secure checkout

One of our team members will be in contact with you once your registration is competed.

Step 1 of 3 - Program/Location

Select a Program*
Days of Interest (1)*
Days of Interest (2)
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
How did you hear about us?*
Start Date*
DD slash MM slash YYYY

Parent Name*
First Last
1st Student Name*
First Last
Age 1st Student*

for ex. 6 Years
2nd Student Name (Optional)
First Last
Age 2nd Student

for ex. 6 Years
3rd Student Name (Optional)
First Last
Age 3rd Student

for ex. 6 Years
Phone Number*
Email*

Select option*
- 1 Student $ 99.00
- 2 Students $ 198.00
- 3 Students $297.00
Credit Card
Card Details
Cardholder Name

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