Online Green Stripe Registration (print in landscape format - 2 pages)

Your Green Stripe testing will be in your regular class during Green Stripe Week.

You need to have this registration returned to your instructor with Parent permission and School Teacher permission signed and the appropriate fees included. Due to the amount of scheduling and ordering of belts there is a $15.00 late fee for late return of the registration to your instructor the week prior to the Green Stripe Week.

Your DoBok should be hemmed, clean, pressed with a proper belt knot.

Yellow belts and above need to have all sparring gear.
Items missing will be sold to you when you check in at the entrance so you can continue your promotional testing.

(student’s name) ________________________ will: (choose options 1 or 2 )

1) test from belt colour of ____________to a new belt colour of ____________ and at the size of _________ .

2) mid-tern test number ____at current ___degree black belt toward the next ____ degree black belt.

Promotional Testing Fee of $_____

$15.00 late fee if this is not to your instructor before ‘Green Stripe Week’. $_____

Purchase of sparring gear set. Regular price $150.00 at promotional only $125.00 $_____

Purchase of your Curriculum DVD or VHS video (circle your choice of DVD or VHS ) for new instructional block. Regular 29.95 at promotional $15.00 $_____

$10.00 DISCOUNT for each “Help Enrol A New Student” - minus $10.00 $_____

(Student you “Helped To Enrol” ___________________________)

(Student you “Helped To Enrol” ___________________________)

(Student you “Helped To Enrol”____________________________)

(Student you “Helped To Enrol”____________________________)

My Son/Daughter has been cooperative and helpful at home and has my permission to test.

Parent signature __________________________

This student is respectful and courteous to teachers and fellow students and completing satisfactory or better work at school.

Teacher signature ___________________________

Students return this permission and registration to your instructor before ‘Green Stripe Week’ or it is subject to a LATE FEE.

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