NYFA Online Club Registration

NYFA Online Club Registration
NYFA Location *

NYFA-BK: 2896 W 12th St, Brooklyn, NY 11224 NYFA-LI: 8 Haven Ave, Port Washington, NY 11050
Contact Information
Fencer's Name *

First Name Last Name
Fencer's Cell (optional)

Area Code Phone Number
Email Address *
example@example.com
Parent/Guardian *

First Name Last Name
Parent/Guardian Phone *

Area Code Phone Number
Home Address *

Street Address

Street Address Line 2

City State

Zip Code Country
How did you learn about us?

Internet Referral by a friend Print or radio ad News or magazine article From school
Fencer's Information
Date of Birth *

Month Day Year
Gender *

Female Male
Fencing Experience *
Years
Age Group
USA Fencing Member ID *
Competitive Membership? *

Yes No
Additional Comments, Allergies, Health Issues
Terms & Conditions
Fencers & Parents: Please review the following policies: safety, membership, payment, cancellation; photograph/sound/video release; waiver of liability; and consent for medical treatment. Then check "Agree to Terms & Conditions".
Sign below (on screen by touch, mouse, etc.) to confirm that you have read and agree to the requirements and Terms & Conditions of the New York Fencing Academy:
Fencer's Signature *

Clear
Parent/Guardian's Signature *

Clear
Additional comments?

0/150
When completed, press submit to send to NYFA
and you will also receive a copy by email.

Thank You!
Should be Empty:

Contact Information