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Three Rivers Defense Trainee Questionnaire

Name

First Name

Last Name

Email address

Telephone number

Have you ever participated in any self-defense training? If so, what? When? Any martial arts training?

What are your expectations and goals for your training? Are there any particular safety or physical defense issues that you would like us to address? Are you looking primarily for physical training or are you also interested in personal safety / violence dynamics training?

Have you ever been the target of any physical or other violence? If so, please describe if you feel comfortable doing so.

Do you have any concerns or questions regarding the training?