Judo PEI 2018 Camp Registration

2018 Camp Registrion Form
Campers Info *

First Name Last Name
Gender *
*

Month Day Year
Date of Birth
*
Belt Level
Home Judo Club
Name and Location
Club Sensei
Message (Please Note any Medical Issues or dietary restrictions)
Consent *

The athlete is under 18 years old and I am giving my consent as legal guardian I am over the age of 18 and filling out this registration for myself
Name of Person Submitting Application *
Name
Phone Number *

Area Code Phone Number
E-mail *
Type a question *

Junior Camp - Aug 27- 29 - $175 Competitive Camp - Aug 29 - Sept 1 - $225
You will be sent an Invoice within 24 hours - please copleet and fill out ASAP
Should be Empty: