Annex Judo Academy Registration - 2021 - 2022
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Email *
Name *
Address *
Phone number *
Emergency contact - Name and number *
Date of birth *
MM
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DD
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YYYY
Years of training *
Belt level *
Judo Ontario/Judo Canada Number (if known)
Do you have any coaching or refereeing or first aid qualifications? *
If you answered 'yes' to the above question, please list your qualifications below.
Do you have any family enrolled in our program? *
Do you have any allergies or medical conditions that the instructors should be aware of in order to better accommodate your training? *
OHIP Number (optional)
Do you have both doses of a Health Canada approved Covid-19 Vaccine? Please email a copy of your vaccine certificate to annexjudoacademy@gmail.com *
Is there anything else that you would like to tell us to better serve you? *
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