Kenner Police Department

Women's Self-Defense Application

Our next Women’s Self-Defense class will be held January 13, 14 & 15 2025

First Name

Middle Name

Last Name

Date Of Birth

Email

Phone Number

Street Address

City

State

Zip Code

Do You Have Any Pre-Existing Injuries? If Yes, Please Describe Below:

Current Fitness Level (Check One)

Beginner Intermediate Advanced