* 1. Address 1

* 2. Please list any health issues the enrolling student has that the instructors should be aware of, as well as any other information about overall student health that is important for instructors to know.

* 3. What is the top reason you are enrolling in or continuing martial arts study at Oakland Kajukenbo Kwoon?

* 4. Which classes will you/your family be attending each week?

* 5. How important is it to you that Oakland Kajukenbo Kwoon is an intergenerational learning environment?

  I am passionately in agreement I agree, generally I am of a mixed view I do not have strong feelings about this This is not true for me at all
I/we chose this program specifically because people of all ages regularly train in Kajukenbo together.
I/we value intergenerational education but it is not central to my/my families continued participation.
I/we find it challenging and would prefer all age segregated classes for my/my families Kajukenbo training.

* 6. How important is it to you/your family that Oakland Kajukenbo Kwoon has a sliding scale/donation based class fee system?

* 7. Please indicate how the current class schedule works for you/your family

* 8. Indicate which of the following activities you/your family would be excited to participate in this upcoming school year.

* 9. Indicate which of the following activities you/your family would be excited to participate in this upcoming school year.

* 10. Please indicate the amount ($0 on up) you/your family will offer Oakland Kajukenbo Kwoon each month as your class fee this school year (2015-2016)

* 11. Do you have any other comments, questions, or concerns?

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