Vadiação Registration - Grupo Senzala

* Indicates required field

Name *

First

Last

Date of Birth *

Gender *

City where you train *

Address *

Mestre/Teacher/instructor *

Apelido/ Capoeira nickname *

Phone Number *

T Shirt Size *

Email *

Corda *

Date you received your corda. *

How long have you been part of our Grupo *

Medical condition / injuries *

Comment *

Tick the box *

I hereby confirm that all information is correct to the best of my knowledge

Submit