Muay Thai Form

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Your Name *

First

Last

Email *

Age *

Phone *

Emergency contact number - include relationship

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Do you give your consent for us to use your pictures and video on any of our platforms? *

Are you currently under a doctor's care: *

If yes, might the issue be a problem with these sessions?

Do you have any heart problems? *

Do you suffer from diabetes? *

Do you have high blood pressure? *

Do you have any injuries? *

Do you have any joint or muscle problems? *

Are you physically active? *

Have you ever practiced martial arts? *

Any other relevant information? If so please give details.

To the best of my knowledge, the above information is true and correct. I understand that I participate in these sessions entirely at my own risk. *

Do you have any questions?

All our teachers are outstanding graduates in the Quranic field.

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