Police Judo Junior Registration

Registration Form

Please download and complete the Judo BC Individual Membership Registration Form.

Upload Registration Form *

Please download and complete the Police Judo Waiver.

Upload Waiver *

Do you have a Judo Canada number?*

Yes

Judo Canada Number

Guardian First Name*

Guardian Last Name*

Guardian Email Address*

Guardian Phone Number*

Guardian Gender*

Participant First Name*

Participant Last Name*

Nickname or commonly used name*

Participant Date of Birth*

Care Card Number (PHN)*

Participant Email Address (Optional)

Home Address (Optional)

Gender*

Current Judo Belt*

Emergency Contact 1 Name*

Emergency Contact 1 Phone Number*

Emergency Contact 2 Name*

Emergency Contact 2 Phone Number*

Class *