Judo & Wrestling Center

Membership Application

Fill out the form below and our team will contact you to confirm the next step.

Applicant Information

Are you 18 or older? Yes No

Full Name Date of Birth Gender Phone Address Email

Emergency Contact

Name Relationship Phone

Medical Information

Any medical conditions or allergies Current medications

Experience

Have you trained in Judo or Wrestling before? Yes No

Membership

Program Judo Wrestling Both

Preferred Training Days

Agreement

I understand that martial arts training involves physical activity and accept the risks associated with participation. I agree to follow all rules and instructions of the Judo & Wrestling Center.

I have read and agree to the statement above.

Signatures

Applicant Signature Date