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:*

    location:*

    trial class 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*

    MF
    Street*
    Housenumber*
    Additions
    Postal code*
    Town/city*
    Telephone number*
    2nd Telephone number (optioneel)
    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. a )

    Comments