Name *
Name
Address
Address
Phone
Phone
Best Way to Reach Me *
Section 1
Parent/Guardian #1 Phone Number
Parent/Guardian #1 Phone Number
Parent/Guardian #2 Phone
Parent/Guardian #2 Phone
Section 2
Have you had previous Martial Arts Training?
Section 3
Section 4
CAE's funders require us to obtain statistical information in order to report more accurately about who our participants are. The information on this form will be anonymous. Completing this form is voluntary, but please note that you cooperation is extremely benefit t o CAE. When appropriate, please check all boxes that apply.
Gender Identity
Age
Race/Ethnicity (Please Check All That Apply)
Family Income Level
Sexual Orientation
Borough/Town: