Xcite MMA Member Details Form | Finalize Your Enrollment

435-660-5811

14632 Heritage Crest Way, Bluffdale Utah 84065

Last Step! Important

Please be sure to complete this, if you don't have all the info, save the page

and put a reminder to come back and complete it.

Please Complete the Following Information Now.

You will not be allowed at any future classes without the following info provided.

*If you are enrolling less than 5 participants, just fill out the info for the # of participants enrolling.

**If you are enrolling for yourself, just fill in your info for Participant 1 details as your own details then skip down to emergency and insurance info.

***If you already enrolled someone in the family skip the Number of participants already enrolled and start at the additional Partipant # (ie if you have 2 people enrolled skip participant 1 and 2 and fill out info for participant 3.)

****Weight is asked because this is a weight class sport.

Full Name *

Email *

Date of Enrollment

Participant 1's Full Name *

Participant's 1 Age

Participant's 1 Weight

Participant 1's Years of Experience in Combat Sports

Participant 2's Full Name

Participant's 2 Age

Participant's 2 Weight

Participant 2's Years of Experience in Combat Sports

Participant 3's Full Name

Participant's 3 Age

Participant's 3 Weight

Participant 3's Years of Experience in Combat Sports

Participant 4's Full Name

Participant's 4 Age

Participant's 4 Weight

Participant 4's Years of Experience in Combat Sports

Participant 5's Full Name

Participant's 5 Age

Participant's 5 Weight

Participant 5's Years of Experience in Combat Sports

Emergency Contact Name *

Emergency Contact Phone Number *

Emergency Contact Relationship to Participants

Health Insurance Company Name (Put I will Cover Personally if no insurance)

Health Insurance Phone Number (Put N/A if no insurance)

Health Insurance Policy Number (Put N/A if no insurance) *

Notes

Testimonials

I have been going to this gym 4 days a week for a few months now and I am pleased with the results.

Carson is a good coach and really helps me get what I need out of the workouts. The other coaches are great as well. The atmosphere in the gym is amazing.

The people who attend are great and in general everyone has the desire to improve which makes working out there more worthwhile. No one is judgmental or belittling. All in all I am extremely grateful to be able to train at this gym.

Spencer Hansen

My experience at this gym has been great. I have grown a lot as a fighter and as a person in the short little while I’ve been here.

Carson puts in a lot of effort to make sure his students learn as much as possible and the opportunity for growth in the gym is huge. Carson saw potential in me I didn’t even see in myself and as a result I am pushing myself beyond what I originally thought I was capable of.

If you want to see yourself grow, this is the place for you.

Jordan Jones

Carson is a true coach—the kind you only see in movies.

Not only does he share his phenomenal MMA expertise, but he also is a mentor and role model, with an intuitive talent for knowing when to push students and expect more and when to allow for some space and encouragement.

The other instructors and students also come together to form a fun and supportive community we haven’t found anywhere else. So glad to be a part of Xcite MMA!

Karen Stoianov