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Class Times and Locations

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Registration Form

We're so glad you're interested in T.A.K.E. Defense Training! Please fill out the form below to register or volunteer, and you'll be well on your way to being a more powerful you.

Name

First Name*

Last Name*

Date of Birth*	// Example: 08/08/1971

Address

Mailing Address*



City*

State*
Zip Code*

Contact

Daytime Phone*	Example: 816-123-4567

Email Address*

Confirm Email Address*

Class and Volunteer Information

I am interested in (check all that apply)

Taking a class Volunteering

T.A.K.E. DEFENSE CLASSES

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VOLUNTEER OPPORTUNITIES AT T.A.K.E. DEFENSE
I would like to volunteer as a (check all that apply)

Greeter	Registration Clerk
Room Monitor	Equipment Set-up/ Tear Down

Waiver

For everyone's safety, all participants are required to submit a waiver form. Please print and sign the form, and bring it with you to the T.A.K.E. session you're attending.

If you're under 18, you'll need your parent or guardian's signature on the waiver form.

TAKE Foundation™ Defense Training