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FRANÇAIS

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CLUB DE JUDO HAKUDOKAN

Montréal, Quebec

01. Registrant InformationRegistrants
02. Confirmation & PaymentConfirmation
03. ReceiptReceipt

# of individuals you want to register

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Registrant #1

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Are you sure this individual isn’t the following:

Are you a new or renewing member? *Judo Canada # * Lookup I am a new member

I am new to Judo Canada
I am already a member or am renewing my membership
with Judo Canada

First Name *

Last Name *Is your Name incorrectly spelled?

Gender *

Male Female Other

Date of Birth * (YYYY-MM-DD)

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No category for this age.

School Name

Full Mailing Address - Street Address *

Address 2

City *

Province/State *

Country *

Postal Code *

Individual Email * Opt in to emails

Home Phone * - International Number

Work Phone - International Number

Visually Impaired *

No Yes

Physical disability *

None Deaf Autistic Other

Indigenous Descent *

No Yes

Please select each option that applies to this member *

Profile Photo

NCCP #

Belt Level *

Is this person in a position of authority during judo activities? *

Coach Assistance coach Judge Volunteers Employees None

The member wishes to receive promotional information and newsletters from Judo Quebec and Judo Canada *

Yes No

Emergency Contact Phone * - International Number

Membership type

Notice: You have reached your maximum number of individual entries for this registrant.

There are no available categories for the age of this registrant.

Add another membership type

Membership type (Judo Québec)

Introduction is a once in a lifetime 15-week program whereas Mudansha is for the year.

Membership type *

Category *

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Membership type (Judo Canada)

Membership type *

Category *

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Additional Purchases

Judo Quebec Passport

$6.00

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