Loading...

UMAD New student form

To better serve you in our martial arts program, please fill out the short questionnaire below.

  • Thank you for taking time out of your busy schedule to view our Academy! We are sure your time with us will be beneficial in your personal quest, here at UMAD we not only teach martial arts, but life skills that will be valued for years to come.

    Below is our new student questionnaire, we ask that you fill out all items and if you have any questions please feel free to ask. We offer pre-school classes, youth development, group seminars, self-protection, and fitness courses. Our way is to lead by example not only on the mat but off,and to leave a great impression to each person we meet.

    We proudly teach the Chuck Norris System and we are here to make a difference no matter age, nor if you plan to take a two-day seminar or be invested for years to come. Whatever your goal may be we plan to help each step of the way.

    UMAD.CNS Creed - Red, Black and Gold we Bleed!


  • Make Required

  • Make Required

  • Make Required

  • Make Required

  • Make Required

  • Make Required

  • Make Required

    Map this to an SPARK field:

  • Make Required

    Map this to an SPARK field:

  • Make Required

    Map this to an SPARK field:

  • Make Required

  • Make Required

  • Make Required

  • Make Required

  • Make Required

  • Make Required

  • Make Required

    Map this to an SPARK field:


  • Make Required

    Map this to an SPARK field:

    Selection Box Items (seperated by commas)

  • Make Required

    Map this to an SPARK field:

    Checkbox Items (seperated by commas)
  • Strongly DisagreeDisagreeNeutralAgreeStrongly Agree
    My Child Is Well Behaved At Home
    My Child Is Well Behaved At School
    My Child Is Confident In School
    My Child Is Confident At Home
    My Child is Athletic
    My Child Is A Leader
  • I agree

    The participant/parent/guardian agrees to comply with the rules of Universal Martial Arts Dojos. Parent/guardian/participant acknowledges that participation in this event involves physical contact and other activity, which may result in injury to the participant. 

    In consideration for allowing the participant to participate in this event participant/ parent /guardian hereby releases and waives any and all claims or causes of action against Crosby Broadwater III, Universal Martial Arts Dojos, all directors, staff, employees, agents, officers, volunteers and/or insurance carriers, or any other person(s) connected with Universal Martial Arts Dojos, for any injuries of whatever nature the participant may sustain while participating in, spectating, attending, and/or leaving Universal Martial Arts Dojos.

    Parent/participant/guardian acknowledges that participant is physically and mentally fit to participate in class workouts.  Lastly, participants/parents/guardian hereby waives any compensation whatsoever for use of pictures, videotape, media coverage, statements, interviews, etc., utilized by those producing or directing this event at any time. I understand there is a no refund policy on any monies I will pay Universal Martial Arts Dojos



 


go back

Processing

One moment please.

Thank you.

Thank you, please hand the instructor the tablet to start your first lesson!