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Kickboxing with Genesis Martial Arts
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Brown Belt White Stripe
Tag Course
Please use the form below. Your answers will open up new areas of the form.
Brown Belt White Stripe Tag Courses
Course Date
*
24th September 2023
15th October 2023
Time and Location
9am - 12 noon - Court Garden Leisure Complex Pound Lane Marlow SL7 2AE
I have already passed this course and this is a refresher
*
Yes
No
Instructor Name
*
Please select
Corey Cain
Fitzroy Connor
Joel Hoyte
Matthew Jackson
Main Training Centre
*
Please select
Amersham - Amersham School
Beaconsfield - The Beacon Centre
Hedgerley - Hedgerley Memorial Hall
High Wycombe - Wycombe Sports Centre
High Wycombe - Disraeli School
Langley - Langley Academy School
Stoke Poges - Stoke Poges Village Hall
Student Details
Student first name and surname
*
Date of Birth
*
DD slash MM slash YYYY
Address
*
Address Line 1
Address Line 2
City
Post Code
Phone
*
Email
*
Licence No:
My licence will be valid at the time of the course
*
Yes
No
If your licence has expired or will expire before your course please renew it now.
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to enter the form online.
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Price:
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Price:
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