Aylwin Judo Club Badge
Aylwin Judo Club
Aylwin Judo Club Badge
075 1922 7303
No Thursday class until further notice. Judo Every Tuesday.

Aylwin Judo Club Registration Page

Please complete this form

Should you not be able to complete this form at least 24 hours before you visit the club then please bring a print out with you.
This form must be completed by someone who is aged 18 years or older. When you click on the Register button below you are accepting all the terms and conditions of the Aylwin Judo Club as if you had signed a paper form.
The only optional fields are Address 2, Address 3 and if over 18 years of age, Name and Surname of the Applicants Parent/Guardian.
When you click the register button you are giving your permission for photographs to be taken and placed on the Aylwin Judo Club website and used in any relevant press releases. (Please speak with someone at the club if this causes a major problem.)

2013 New Years Resolution
Tick this box if you are interested in beginners only classes and we will contact YOU nearer the next start time. Do not tick the box if you are going to join us before the next beginners course.  

Applicant Details

Title Name Surname Gender Date of Birth

Contact Details - Parent/Guardian if under 18 years of age

Address 1 Address 2 Address 3 Post Code City
Phone E-Mail

Parent/Guardian (For applicants under 18 years of age)

Title Name Surname Relationship

In Case of Emergency (ICE)

In case of emergency is exactly what it says. In the unlikely event of a member of our club becoming unable to communicate for themselves we need to be able to:

  • Contact someone who has a precise knowledge of their medical history.
  • Communicate accurately, on their behalf, with the emergency services about severe allergies to particular medication.
  • Communicate accurately, on their behalf, with the emergency services about an existing medical condition.
TitleNameSurnameRelationship
Phone
Relevant medical conditions

Finish Registration.

   
Cancel to quit.