Villari's Self Defense & Wellness Center, LLC
Calendar of Events
Low Impact Kempo
On Line Application
Satellite Locations- Calendar
Form - Online Application
This is an online application to request information ONLY this is not a student application.
Name of Sender
** Villari's Self Defense reserves the right to dismiss any student at any time for misconduct or actions that may convey a bad image of this studio. ** Villari's Self Defense is not responsible for any injuries suffered while on the premises.
** I understand that this is a contact form of Martial Arts and that I am responsible for my actions and injuries inflicted upon others or myself and will not hold Villari's Self Defense & W.C, their instructors, and affiliates responsible (including all sub locations).
** We are not responsible for your class attendance that is the responsibility of the student.
Date of Birth
Digital signature- By typing your name this is a legal signature.
Why do you want to train?
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