CFC ONLINE CLASS REGISTRATION
            

THE NEXT 8-WEEK CLASS SESSION BEGINS AUGUST 29, 2005...

Online Registration makes it faster and easier for you to complete the "paperwork" requirement for admission to classes.  In addition, as classes fill quickly, it ensures a space for you in class.

A few notes...

1) This information is kept confidential and is NOT shared with any other group or organization - EVER!
2) After submitting your information, you will be directed to a page confirming the info that you sent !
3) Always feel free to email us, or call, to ensure that we have received you registration form.

Email:  concordfencingclub@hotmail.com►

Concord Fencing Club: (603) 224-3560

REMEMBER:  If you are submitting this 1st PAGE of your application here, you MUST also print out the Medical History Form and Safety Pledge to be COMPLETED and either mailed in or brought to the first class to fulfill the registration requirements!

CFC ONLINE STUDENT MEMBERSHIP REGISTRATION FORM- PAGE 1
NAME: AGE: DATE OF BIRTH:
STREET ADDRESS:
TOWN/CITY: STATE: ZIP:
HOME PHONE:              EMAIL:

PARENTS/GUARDIANS NAMES & CONTACT INFO:
FATHER:
WORK PHONE:                                 FATHER'S CELL PHONE:
MOTHER:
WORK PHONE:                                 MOTHER'S CELL PHONE:

MEMBERSHIP STARTS (1ST CLASS DATE): 

CLASS LEVEL (CHOOSE ONE):

PREVIOUS EXPERIENCE:

 


 
CURRENT USFA MEMBER?                  USFA MEMBERSHIP TYPE:
WEAPON RATINGS:    FOIL:                   EPEE:                     SABRE:
REFEREE RATINGS:    FOIL:                  EPEE:                    SABRE:
USFCA COACHES COLLEGE LEVEL:  FOIL:  EPEE:  SABRE:
CURRENT USFCA MEMBER?:
SPORTS SAFETY TRAINING?:     YEAR:    CPR TRAINING?:    YEAR:
OTHER:
MY MINOR CHILD WILL BE TRAVELING TO/FROM CFC WITH:

BY INITIALING THIS APPLICATION AS A SUBSTITUTE TO YOUR WRITTEN SIGNATURE, YOU ARE CERTIFYING THE ACCURACY OF THE ABOVE INFORMATION AND PARENTAL PERMISSION FOR YOUR MINOR CHILD TO APPLY FOR MEMBERSHIP AT CONCORD FENCING CLUB.

NOTE:  YOUR FULL SIGNATURE WILL BE REQUIRED ON YOUR APPLICATION AT THE FIRST CLASS MEETING !
SIGNATURE (INITIALS) HERE:                                                                  DATE: