Judo Canada - Membership and event registration

Are you a new or renewing member? *

First Name *

Last Name *

Gender *

Male Female

Date of Birth (YYYY *-MM-DD)

/ /

Weight Class *

Belt rank *

Hometown *

Club *

Medical Insurance Card Number *

List your top 3 results *

Indicate all illnesses and injuries that have affected your training in the last 12 months or permanently *

Emergency Contact

Emergency Phone * - International Number

Name *

Emergency Email * Opt in to emails

I hereby authorise Judo Canada and its affiliated associations to use my images for the Judo Canada and its federations’ website, for social media and for judo-related publicity.J'autorise par la présente Judo Canada et ses associations affiliées à utiliser mon image pour le site Web de Judo Canada et de ses fédérations, pour les médias sociaux et pour la publicité liée au judo. I declare that all the information presented on this application form is exact and complete. I understand that numerous rules will apply, and accept to follow them. I accept that Judo Canada reserves the right to remove my access if any breach of rules is found. *

Division

Category *

Next Gen Academy Summer

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Emergency Contact

Division

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Emergency Contact

Division

Which Province/Territory?

Which club do you want to join?

Which club do you want to join?

Contact your club admin to register.

Which club do you want to join?

Which club do you want to join?

Which club do you want to join?

Which club do you want to join?

Which club do you want to join?

Contact your club admin to register.

Which club do you want to join?

Contact your province admin to register.

Which club do you want to join?

Contact your club admin to register.