Form

Boston Kokikai Aikikdo Children's Class
Parent Information:
First Name
Last Name
E-mail
Address
City
State
Child Information
Child's First Name
Child's Last Name
Child's Gender
Child's School
Child's Date of Birth
Class Start Date
Number of children enrolling
Payment Information
Type of payment preferred	Cash/Check mail - click submit and you are done! Cash/check bring to first class -click submit and you are done! Visa,MC,AMEX, direct debit through PayPal check an option below
Children's Program	Fall Semester New Student Special (9/15-12/15) ($160) Fall Semester (9/15-12/15)Continuing Student/No Uniform ($130) Spring 1 Semester (January 15-April 15) continuing student ($130) Spring 1 Semester (1/15-4/15) New Student Special ($160) One Month/Deposit ($45) Sibling with uniform (9/15-12/15) ($90) Sibling no uniform (9/15-12/15) ($75) Total : $0