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    Enrolmentform

    Are you interested in taking judo lessons with JAA? Please fill in this registration form.
    Registration is on the condition that your trial lesson was acceptable.

    Boxes with an * are compulsory.

    I am registering for judo classes:*

    on_location:*

    desired_date_trial_lesson_on:*

    Personal details new member

    If you are registering for parent/child judo classes, please register under the name of the child.

    Surname*

    Initals*

    First_name*

    Date_of_birth*

    Gender*
    MV

    Street*

    Housenumber*

    Additions

    Postal_code*

    Town/city*

    Telephone_number*

    2nd_Telephone_number_(optional)

    Email*

    2e_Email_(optional)

    Please state if any of the following apply:

    Do you hold a stadspas? Stadspas holders do not have to pay the registration fee for members under 18 years of age.

    Stadspas number (19-digit code under the barcode on the reverse side of you pass.)

    Comments