Counterstrike and Self-Defense

Name*

First Last

Email*

Phone*

Please reserve my place in the self defense workshop being given on:*

Question/ Comment?

How Many People Am I Bringing?

These are the persons that will be attending with me.

First Name	Last Name	Phone	Email

Non Refundable Deposit Per Person*

Price:

Total Group Cost:
1 person: $129.95/person
2 or more: $65/person

** Special Group discounts for 6 or more

Total

$0.00

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COUNTERSTRIKE SELF-DEFENSE - "Never Feel Powerless Again"