Fortunato Karate’s

10-Week Fitness Kickboxing 

Registration FORM

___ Yes, Jim. Sign me up for your 10-Week Fitness Kickboxing Class. I’m ready to get in Kick-Butt shape, relieve stress, learn self-defense and have fun doing it. I understand the classes will start Saturday, January 12th at 9:30 am and run for 10 consecutive weeks.  I will also commit to giving my 100% effort and enthusiasm to training. I'm also one of the first 20 people to enroll so I want to save $50 and pay only $197.

___ Enclosed is my check or credit card for $197

Charge my:     Visa       Mastercard       Discover  Card

Number:_________________________________Exp.Date:__________ 

Signature: ____________________________________  

Full Name: _____________________________________________ 

Address: _______________________________________________ 
 
City: ____________________ State: _____Zip Code: ____________  
 
Telephone: ___________________  Cell Phone: __________________
 
E-Mail: __________________________________________  
 
Mail This Form or Drop off at:

Fortunato Karate

20 Timberline Plaza

Woodbury-Glassboro Rd.

Sewell, NJ  08080

You may also register by phone by calling 464-0402!