Développement Repentigny 2024 - COACH

Clear Form

November 30th - December 1st, 2024Repentigny, Quebec

01. Registrant InformationRegistrants
02. Confirmation & PaymentConfirmation
03. ReceiptReceipt

It is mandatory to be a member in good standing of Judo Quebec 2024-2025 before registering.

# of individuals you want to register

* Required fields

Are you a new or renewing member? *

First Name *

Last Name *

Gender *

Male Female

Date of Birth (YYYY *-MM-DD)

/ /

Club *

Email address *

Phone number *

NCCP level (canadian coach only) *

NCCP number *

Si vous serez entraîneur pour un autre club que votre club d'affiliation, svp, l'indiquez ici.

Participants Signature

Division

Category *

Waivers

I have read and agree *
Waiver

Digital signature (type your name exactly as entered above "registrants name") *

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