Universal
Kempo
Karate
Schools
Association
Convenient Online Registration

Register online for your Free Introductory Lesson

To get started in the Free Introductory Lesson, there is a little bit of paperwork that we are required to fill out. This is used to record basic information like name, address, age, gender, etc. Once you fill out the following info and hit Submit, we will call you to schedule your lesson.


Student Info

First name: Middle: Last:

Male     Female     Student Birthdate (MM/DD/YYYY):

Parent's info (if student is under 18)

First name: Middle: Last:

Contact Info

What is the best time to contact you to schedule your free intro?

Daytime Phone Number: Evening Phone Number:

Please choose the best day and time for your lesson:

Monday 6:15 PM (During the family class)
Thursday 7:15 PM (During the adult class)

Will you be bringing a friend?: Yes     No

or scroll down to continue with the optional part of the form
The following information is optional at this time. If you provide it, we will transfer it to the paper forms and have them waiting for you. If you prefer, you can fill this out manually when you arrive.

Reason for learning Kempo Karate (Check all that apply)

Self-defense
Physical fitness
Self-confidence
Self-discipline
Improved Focus
Fun activity
Other 

Previous martial arts experience (if any):

Contact Details

Street Address:
City: State:     Zip:

Name of School or Employer:
Grade or Occupation:
Email Address:

Medical Information

Student weight (pounds):      Student height (inches):
Are you currently under a doctor's care?: Yes     No

If yes, please explain and provide doctors address & phone number

Doctor's name:     Phone:
Street Address:
City:     State:     Zip:
List any known physical problems:
Rules, Details and Legal Junk
  • Fill out and submit the Online Intro Request
  • Complete the 45 minute introductory lesson
  • A legal guardian must accompany any minor child
  • That's it!

Pledge of allegiance before a tournament

"You cannot succeed if you do not try"

  - Anonymous

For more information or to schedule your free introductory lesson, call 719-282-6885