New Student Application

▻ New Student Applicant's Information

Please ensure that all necessary information is provided for each applicant.
Up to four applicants residing in the same household may be included in this application.
If the number of applicants exceeds four, additional New Student Applications must be submitted.

#1 Student Information

#2 Student Information

#3 Student Information

#4 Student Information

▻ New Student Applicant's Address

Please provide the primary residence of the applicant(s).

▻ New Student Applicant's Primary Contact Information

If the applicant(s) is under the age of 18 provide a parent’s or legal guardian’s information.

▻ New Student Applicant's Additional Contacts Information

Include any additional or emergency contacts.

#1 Additional Contact Information (Optional)

#2 Additional Contact Information (Optional)

#3 Additional Contact Information (Optional)

▻ New Student Special

The applicant(s) is cognizant of and intends to utilize the following Groupon coupon for the New Student Special.

Note: The New Student Special must be purchased from Groupon prior to attending the orientation class.

▻ Applicant's Waiver & Release Agreement

By submitting your application, you acknowledge that the American Institute of Kenpo (AIK) is not liable for accidents, injuries, or loss of personal property. Applicants and/or Parent/Guardian hereby affirm that the Applicant is physically fit and has medical clearance to engage in normal exercise routines.

Note: The New Student Application must be submitted by the day preceding your Orientation Class. Failure to submit the application in a timely manner may result in the rescheduling of your Orientation Class for a later date.

For rescheduling you can reach us at (520) 744-9004.

Your Application Has Been Submitted!