Private Martial Arts Lesson Request

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Here's your chance to receive instruction in a specialized area! Focus on Shaolin Kung Fu, Kemp Karate, Ju Jitsu, Aikedo, or Tai Chi.
These are 30-minute or 60- minute sessions. 
 

Please choose the type of service you are requesting.

Here's your chance to receive instruction in a specialized area! Focus on Shaolin Kung Fu, Kemp Karate, Ju Jitsu, Aikedo, or Tai Chi. These are 30-minute or 60- minute sessions. Please choose the type of service you are requesting.
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Name of Person Requesting Lesson

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Age of Person Requesting Lesson

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Contact Information

Contact Information
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Address

Address
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Emergency Contact Information

Emergency Contact Information
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Preferred Day(s)/Time(s)

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Special Considerations

Thank you for your request for private martial arts lessons. Please make note of the following:

*All services are by appointment only.
*There are no discounts on the cost of any services.
*Clients must pay for all services in advance.
*Sessions are approximately thirty minutes.

*To cancel a private lesson, YOU MUST CONTACT YOUR INSTRUCTOR DIRECTLY WITH 24 hours of your
scheduled session. Failure to cancel will result in you being charged for the session.
Clients who arrive more than 15 minutes late will be charged for the session. In addition, the instructor
may cancel the session.
*Private lesson fees are subject to change.

*Participant assumption of risk:

I understand that participation in any activity involves inherent risks, and that even when safety
precautions are utilized, injuries can occur. I fully agree to assume all risks involved when following instruction prescribed
by Ida Lee Recreation Center and its instructors, and agree to hold them harmless in the event that such injury occurs. If I experience unusual pain or discomfort during participation in any activity, I will inform the instructor immediately. I am aware that personal health/accident insurance is my responsibility. I claim that to the best of my knowledge, I do not have any medical issue that will prohibit my safe participation in this program.
By submitting this form, you agree to the above policies.
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