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Portland Academy of Self-Defense

10-Day Introductory Training Program
Qualification Form

Before claiming your 10-Day Introductory Training Offer, please answer the following questions.

1Which program are you interested in?

2Are you looking to start training right away?

3Approximately how far do you live from our academy?

4Besides yourself, is anyone else involved in the enrollment decision?

5If the program feels like a good fit and we can make the schedule work, are you prepared to get started within the next 7 days?

6Do you have any injuries, physical limitations, or medical conditions we should be aware of before training?

7Are you currently taking any medication that may affect physical activity, focus, balance, coordination, or participation during training?

Your contact details

So we can reach out to schedule your Discovery Session.

Portland Academy of Self Defense

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