Participant Information

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*Please complete this section if participant is a minor

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By filling out and submitting this form, you give Cancino’s Black Belt Academy, LLC permission to contact you about special offers and classes.  Information collected will be solely used for Cancino’s Black Belt Academy’s marketing purposes.  Your information will not be shared with any third parties.  You also give us permission to publish any photos taken by our staff on social media and printed material.