Registration Page

Fill out for Free Trial and Registration

Free Trial consists of two free classes, and if you refer someone and they register and pay for a class, you will get an additional free class for every verified referal.

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Athlete's Name *

First

Last

Athlete's Date of Birth xx/xx/xxxx *

Athlete's Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent / Guardian Name *

First

Last

Parent/Guardian Phone Number *

Parent / Guardian Email *

Emergency Contact *

First

Last

Emergency Contact Number *

Athlete's Diagnosis *

Name of Foundation and Case Manager; If any *

Case Manager Phone Number; If any *

Location of Interest *

Jersey City Union Bellville

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Fill out for Free Trial and Registration

Special Dragons Karate ​Info@SpecialDragonsKarate.org ​Phone: 973 667-8525

Special Dragons Karate
Info@SpecialDragonsKarate.org
Phone: 973 667-8525