Junior Class Registration Form

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Please provide an email so we can send you the completed form

Email *

Full name of child *

Date of birth *

Guardian Name

Contact phone number *

Has your child had any experience with Brazilian Jiu-Jitsu, Judo or Wrestling?

Any injuries or additional comments we should know about?

We sometimes take photos to share our on social media and website. Do you consent to having your child's photo shared online?

If you are paying membership for the term and would like to pay a bank transfer, please deposit the amount into the following bank account details:

Balance Yoga & Jiu-Jitsu

ANZ 06-0705-0561027-00

By selecting yes, you are agreeing to the following. Martial Arts is a potentially dangerous activity. Bumps, bruises, scrapes, scratches and soreness are commonplace; most students will encounter this sort of mirror injury from time to time in their training. More serious injuries are possible, including; sprains, strains, twists, cramps and injuries of similar magnitude. By signing this, you assume responsibility for your child's safety.

I understand

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