Please consult your physician before engaging in any exercise or sports program.   DSSI, Cardio Kickboxing, and it's fitness associates are hereby held completely harmless of any accident, illness, injury, or liability which might occur regarding the use or misuse of our products.

Please provide your address and contact information.

Name: ____________________________________________________________   

Phone Number: ____________________ 

Mailing Address:     _____________________________________________________   

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E-mail Address ________________________

Please send this form along with check or money order for total amount to:

Checks should be made payable to "DeValentino Shudokan Schools"

Martial Arts & Cardio Kickboxing
623 Lions Gate Lane
Odenton, MD 21113
tel/fax (410) 674-5506
e-mail: karate@devalentinoshudokan.org

© DSSI 2002 all rights reserved