Registration (SD off)

Online Registration Form

Self Defense Registration

** Online registration must be completed at least 24 hours prior to the start of the class.
If you plan to register on the start date, please do so at class to ensure that your registration is processed. **

Do not complete this form if you are not ready to submit your registration payment. You are not registered if payment is not received.
Please note: AIM registration fee is non-refundable.

* Indicates required field

Student Name *

First

Last

Student Age *

Belt Rank *

Stripes *

Gender *

Male Female

Shirt Size *

Pant Size *

Class Location *

Class Day *

Parent Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

School Student Attends *

Allergies or Medical Conditions to be Aware of *

ATHLETES IN MOTION EAST COAST LLC, AIM USA INC. LIABILITY RELEASE:
By providing my electronic signature below, I, the parent or guardian of the student listed above, do hereby agree to release all liability and claims, against ATHLETES IN MOTION EAST COAST LLC, AIM USA INC, and agree to hold harmless any liability against ATHLETES IN MOTION EAST COAST LLC, AIM USA INC, any sponsoring organization, facility, instructor, and any other party involved, due to any injuries, accidents, negligence, or any other circumstance arising from participation in any ATHLETES IN MOTION EAST COAST LLC, AIM USA INC program / activity with respect to any time prior, during and after class.

Parent Electronic Signature *

Please DO NOT click the button below if you are not prepared to submit payment on the next screen.
Clicking this button without completing the payment portion on the next screen will not register your child for the program.

Continue to Payment Info

If you are interested in being a Parent Helper and receiving a 50% discount on class fees, please click here for more information. Please do NOT submit this online form.