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Edison Martial Arts Academy

 

SAFETY GEAR REQUIRMENTS

      White to Gold: Head Gear  $32.95

      Gold to Green: Chest Protection  $34.95

      Green to Purple: Foot and Hand Gear  $50.00

      Purple: Complete

 

AGE GROUP:

Peewee

Kids

Adult

4-6 yrs.

7-12 yrs.

13& up

FEE SCHEDULE

   Camo         $30

   White        $30

   Gold Belt    $35

   Green Belt   $40

   Purple Belt  $45

   Blue Belt    $55

   Red Belt     $60

   Brown Belt   $65

   JB           $70

 

LAST NAME ________________________

FIRST NAME ____________________

ADDRESS ____________________________________________________________

CITY/TOWN _______________________

ZIP CODE _________________________

PHONE NO. ________________________

DATE OF BIRTH _____________________

AGE _____________________________

 

 

 

PRESENT RANK

RANK GRADUATING TO

BELT SIZE

MONTH OF GRADUATION

White Belt

White Belt

000

January

Gold Belt

Gold Belt

00

February

Green Belt

Green Belt

1

March

Purple Belt

Purple Belt

2

April

Blue Belt

Blue Belt

3

May

Red Belt

Red Belt

4

June

Brown Belt

Brown Belt

5

July

Junior Black Belt

Junior Black Belt

6

August

Black Belt

Black Belt

7

September

1st Degree

1st Degree

 

October

2nd Degree

2nd Degree

(this size is found on

November

3rd Degree

3rd Degree

the uniform tag)

December

 

 

Dear Student & Parents:

 

Please take a moment to read and fill out this application for graduation. Be sure to fill in all the information blanks.

 

This application is only to be submitted to the front desk if the student is on the graduation list.

 

Remember, it takes us time to organize the graduation and order the supplies, so please hand in this application in no later than one week prior to the graduation.

GRADUATION CHECK LIST:

 

3 Stripes

Test Fee

Safety Gear

Complete Patch

Clean, White Uniform

Student Signature

_______________________

Parent Signature

_______________________