JUDO CLASS APPLICATION FORM

(Please fill out and print the form, then fax to 2160 - 1022)

Personal Particular

Name of Player:
Sex:
Age:
Date of Birth:
Judo Experience year(s):
Current grade:
School Attends:
Contact phone numbers:	(Res)
	(Mobile - for emergency contact)
	(Office)
Fax:
Address:
Email Address (for all class correspondence):

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Class Information

Program Venue (Club/ School):
Start on (date):
Time:
Judogi (suit) required:	Yes No