Capoeira Arte

Full Student Name *

Phone Number *

Student
Parent Guardian

Phone Number *

E-mail Student Aged 18 +

Gender *

Prefer not to say
Female
Male

Date of Birth *

Phone Number (Parent/Guardian if under 18)

Select Your Class *

Capoeira Kids (Aged 3–10) – 6:30 PM
Capoeira Adults & Kids (Aged 12+) – 7:30 PM
Capoeira Music / Instruments – Waiting List
Free Trial

Is the Student Under 18? *

Yes
No

Parent / Guardian Name (if applicable)

Email Address (Parent/Guardian if under 18)

Additional Notes (Optional): (Any allergies, special needs, or info we should know)

*Consent (for students under 18 or more) *

I consent to my child participating in Capoeira classes and agree to the terms.
I authorize the use of photos or videos of my child for social media, marketing, and promotional purposes.

Email

info@capoeiraarte.com

Capoeira Class Registration Form