Congratulations!

This truly is a Red Letter Day at Wilcoxen's Family Academy!

Earning your red stripe means you have successfully completed the curriculum needed to earn your place at your new rank. With this in mind, remember, “We Lead by Example,” so there will be other requirements to fulfill. In order to receive your new rank (belt) and certification, you must return this completed form and your $20.00 dollar belt fee one week before you test.



Parental approval:


Should ________________________________ receive their new belt in Karate based on his/her attitude?


____ Yes, since starting the Karate program we have seen a marked improvement in manners and responsibility.

____ Yes, but we are still having some problem areas.


Explain: ______________________________________________________________________________



____ No, we need a conference.

___________________________

Parent Signature




Educator's Approval:

Should _______________________________ receive their new belt?


____Yes, schoolwork and conduct are excellent!


____ Yes, but we still need a little work on:


Explain:

__________________________________________________________________________________________

____ No, we need a conference.


_______________________________ ________________________________

Teacher Signature





Date Paid: ________________________

Paper: ________________________

New rank: ________________________

Testing cycle: ________________________


Received by: ________________________