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Aylwin Judo Club - Registration Page

Judo is a fun exciting Olympic sport. It is great for building confidence and improving your fitness.
However, before you are able to step onto the tatami (mat) we need the registration form below completed.

Applicant Details

Applicants Details

Date of Birth

Contact Details - Parent/Guardian if under 18 years of age

Parent or Guardian

eMail & Phone Details

Address Details

In Case of Emergency (ICE)

In case of emergency is exactly what it says. In the unlikely event of a member of our club becoming unable to communicate for themselves we need to be able to:
Contact someone who has a precise knowledge of their medical history.
Communicate accurately, on their behalf, with the emergency services about severe allergies to particular medication or an existing medical condition.

ICE Details

ICE Phone Details

Relevant medical conditions

If there are no relevant medical conditions then please type None in the box below.

Medical Conditions

Important Information

To send this form you MUST enter your Title, Name, Surname, Date of Birth, Address 1, Post Code, E-mail and one telephone number, as a minimum.

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