Name:__________________________________________________________________________
Address, City, State,
Zip:____________________________________________________________
Home Phone _____________________________ Work Phone
_____________________________
If minor, parents or guardian’s name:
__________________________________________________
PLEASE CHECK THE APPROPRIATE SPACES:
|
BASICS COURSE ___ I wish to take the Basic Course beginning on _________________ at
_________________. |
|
WEAPONS AND MULTIPLE ASSAILANTS COURSE ___ I wish to take the Weapons/Multiple Assailants Course beginning on ______________ at ________________.___ I have enclosed my payment of $300.00 as payment in full. ___ I have enclosed $50.00 as a non-refundable payment to ensure an opening in the Weapons and Multiple Assailants Course is saved for me. Sign up for Both Course ___ I wish to take both courses and I have enclosed $100 as payment to
ensure a space will be saved for me in both classes. Please list both
dates and time for both courses. |
PLEASE MAKE CHECKS PAYABLE TO ZERO HOUR--Mail payments and Application Form to:
Zero Hour: Institute of Self Defense
1222 Magnolia Ave. #105-202
Corona, CA 92881-2075
If I transfer to a future course, I will be charged a $25.00 transfer fee if I notify Zero Hour less than 30 days prior to the 1st class date. I understand that in order to receive a full deposit refund, I must notify Zero Hour 30 days prior to the 1st class date. Additionally, if I begin the course and then decide not to continue, no amount of my tuition will be refunded, however, course credit will be given.
Signature ______________________________________________ Date ________________
(Guardian’s signature if necessary)