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Cubs Brazilian Jiu Jitsu Expression of Interest Form -Truganina Community Centre
Thank you for your interest in signing up for Cubs Brazilian Jiu Jitsu!

Please fill out this form to help us understand your child's needs and preferences. 

Trainer: Sensei Nasser
Rank: Certified Black belt in Brazilian Ju-Jitsu
Experience: 12 years, multiple awards at state level competition. 

Training your cubs to be Lions. 
 What are your most important reasons in registering yourself or your child in Jiu Jitsu? *
Required

Do you have any specific goals or expectations for your child's Jiu Jitsu training?


Are you registering for yourself, partner, or children? *
 Name(s) of those who are registering. *
Contact number and email of those mentioned in previous question, or contact of their legal guardian.  *
Age, gender and weight (in kg) of your child. 

This information is required to structure classes and putting students with similar weight categories and gender
 *
How many classes per week are you interested in?  *
Required
Which days are most suitable for you? *
Required

Child's Previous Experience with Martial Arts (if any):

 *

Does your child have any medical conditions or allergies we should be aware of?

 *

Is your child currently taking any medications? Or taking any regular medications?

 *

Emergency Contact Name and phone number

 *

Is there anything else you would like us to know about your child or the person enrolling?


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