Changes to Class Registration

Choose one

Leave of Absence

Cancellation of Classes

Leave of Absence

Length of notice: If the request is submitted 3 weeks or more before the next billing cycle (the 1st of each month), your account will be charged $60 per month per student during the time of your leave, instead of the regular class fee. If the request is submitted less than 3 weeks before the next billing cycle, your account will be charged $90 per student for the first month, then $60 for the subsequent months during the time of your leave, instead of the regular class fee. *

3-weeks notice: 21 days or more before the next billing cycle (1st of the month)

Short notice: less than 21 days before the next billing cycle

Duration of leave of absence *

1 month

2 months

3 months

Leave of absence start date * +

Cancellation of classes

Per our policy, to which all customers agree before signing up, cancellation of credit card payments for CCIKA classes requires 30 days notice before the next billing cycle (the 1st of each month). IS YOUR REQUEST 30 DAYS OR MORE BEFORE THE REQUESTED CANCELLATION DATE? *

Yes: Cancellation will take effect on the requested date

No: Cancellation will take effect one month after the requested date

Cancellation start date * +

Student Information

Student First Name *

Student Last Name *

Email Address *

Martial Arts Experience

None	Beginner	Intermediate
Advance

Parent/Guardian Information

Parent or Guardian's Name *

Please sign *

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