Welcome to the FJC Seniors Balance & Falls Class!

Please fill out the following information.

For your first practice, arrive 15 minutes before the start time. Wear comfortable workout clothes, slip-on shoes, and bring a water bottle. For safety reasons, do not wear jewelry, hard material on clothing/in hair (zippers, buttons, hair clips, etc), or long nails.

If you have any questions, please contact Sensei Kris at 559-360-7155 or email us at fresnojudo@gmail.com.

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

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JUDO

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FRESNO JUDO CLUB

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Adaptive Judo

$20.00 / MONTH

Please read and sign the following agreements

AUTHORIZATION FOR RELEASE OF INFORMATION AND/OR PUBLIC USE OF IMAGE (PHOTOGRAPH OR VIDEOTAPE) FOR MEDIA AND PUBLIC RELATIONS PURPOSES

Code of Conduct

Welcome to the FJC Seniors Balance & Falls Class!

Personal Information

Emergency Contact Information

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Adaptive Judo

Please read and sign the following agreements

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Welcome to the FJC Seniors Balance & Falls Class!

Personal Information

Emergency Contact Information

You'll be joining:

You're enrolling at:

Enter payment details for this plan

Adaptive Judo

Please read and sign the following agreements

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