Women’s Self Defense Course Registration

Saturday March 11, 2023

1:00pm - 3:00pm

Teen Girls and Women

$21 per person

East Montgomery Martial Arts is offering a two-hour, introductory session to the most practical self-defense techniques that you or your teenage daughter can readily apply to protect your personal space. Empower yourself through a variety of tactics taken from traditional and modern martial arts.

The main instructor for the course is Ms. Josa Hanzlik who is a certified Instructor in the Academy and a Jiu-JItsu coach (you can learn more about her on our Staff Page). Several of our other staff members will be assisting her to ensure you get the best training possible with lots of individual attention in an enjoyable, safe environment.

Please fill out the form for each member of your family attending. After submitting the form, you will be directed to Paypal to complete the payment.

Student Name (*)

Date of Birth (*)

Parent Name (if under 18)

Phone (*)

Email (*)

Address (*)

Are there any medical conditions or special needs that the Academy should be aware of? (*)YesNo

If "Yes", please provide info:

This online registration certifies that I voluntarily submit this registration for the women’s self defense course at the East Montgomery Martial Arts Academy, llc and states that I am / my child is mentally and physically able to participate in this course of instruction. I understand the physical and athletic nature of the activities involved. I understand that participation is at my own risk. I further understand that enrollment is subject to approval by the Head Instructor of the East Montgomery Martial Arts Academy, llc. I understand and agree that I will hold harmless and indemnify the ACADEMY for any and all damages sustained by me or my child or any member of my family whether or not occasioned by the negligent acts and/or omissions of the ACADEMY, its agents, servants, and/or employees or any third party where such damage is a result of any act or omission occurring on the premises of the ACADEMY or at any facility wherein the ACADEMY conducts its business, including, but not limited to, tournament sites, camps, etc. I understand that this means I am releasing and indemnifying the ACADEMY from all claims for damages to me, my child or other members of my family for any and all negligent acts or omissions on the part of the ACADEMY, its agents, servants and/or employees and/or third parties.

Accept the waiver (*)

I Agree

Saturday March 11, 2023 1:00pm - 3:00pm Teen Girls and Women $21 per person

Women’s Self Defense Course Registration

Saturday March 11, 2023

1:00pm - 3:00pm

Teen Girls and Women

$21 per person