Welcome to SouthWest Judo Academy!

New student sign-up form.

Personal Information

FIRST NAME *

LAST NAME *

UPLOAD PROFILE PHOTO

ADDRESS LINE 1

ADDRESS LINE 2

TOWN/CITY

POSTCODE

EMAIL ADDRESS (PRIMARY) *

EMAIL ADDRESS (SECONDARY)

GENDER

PHONE NUMBER

MOBILE NUMBER

DATE OF BIRTH

Emergency Contact Information

NAME

RELATIONSHIP

PHONE

MEDICAL / ALLERGY NOTES

You'll be joining:

STUDENTS

You're enrolling at:

PORT KENNEDY

Choose a plan and enter payment details

1 Session/Week Plan

$60.00 / MONTH

Unlimited Plan

$90.00 / MONTH

EbiKids Term Program

$100.00 / 3 MONTHS

Welcome to SouthWest Judo Academy!

Personal Information

Emergency Contact Information

You'll be joining:

You're enrolling at:

Choose a plan and enter payment details

1 Session/Week Plan

Unlimited Plan

EbiKids Term Program

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Welcome to SouthWest Judo Academy!

Personal Information

Emergency Contact Information

You'll be joining:

You're enrolling at:

Choose a plan and enter payment details

1 Session/Week Plan

Unlimited Plan

EbiKids Term Program

Which contact methods do you consent to?

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