NQJJA Registration Form
  • North Queensland Ju-Jitsu Academy Inc Registration Form

  • Student Information

  •  -

  • Parent/Guardian Information (if student/participant is under 18)

  •  -
  • Alternative Emergency Contact

  •  -
  • Training Programs

    For further information about our Training Programs, please visit our Website - North Queensland Ju-Jitsu Academy Inc

     

  • Acknowledgement

    I understand that all sports carry a risk of injury and that North Queensland Ju-Jitsu Academy Inc is not responsible for injuries or loss suffered as the result of participating in these activities.

    From time to time North Queensland Ju-Jitsu Academy Inc will post photographs of our students, participants, coaches, and supporters online. I will let North Queensland Ju-Jitsu Academy Inc know by email if I do not consent to my or my child’s photos being shared.

  • Medical Authorisation

    In the event of an injury or medical emergency, I allow North Queensland Ju-Jitsu Academy Inc to provide first aid, arrange transport to a medical facility, and authorise emergency treatment as recommended by a doctor for the student named above.

    I understand that all reasonable efforts will be made to contact the athlete’s parent and/or emergency contact if an injury or medical emergency occurs.

  • Confirmation

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

  •  - -
  • Should be Empty: