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Do you have any current or recent injury? (Y/N) If yes, what is it?
Have you had any surgery recently? (Y/N). If yes, what kind?
Have you been cleared by your physician and health specialists for physical exercise?
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I declare that I am capable of fully participating in the physical and mental training by BlackPantherSelf-Defense (Please copy and paste this statement in the space above)
Please select your preferred training time. Select only one.
I understand I must keep all my appointments. No cancellations and no refunds are allowed.
I confirm that I have read and fully understand the terms and conditions of my membership. I sign this document freely.


We hope to partner with you as you embark on this great adventure of your life, a time of magnificent growth and progress. Thank you for your inquiry, and we will get back to you shortly.


©2022 Black Panther Self-Defense Academy. Strong mind, Strong body, Great Life.


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