Oline Registration Form

NGA TOTARA

WELCOME

We are very pleased to welcome you to  Nga Totara Dojo. If you are under 18 years of age, please ask your parents or guardian to complete this form. We will use this information to ensure that you are kept informed of club events, and to register you with Judo New Zealand or Jitsu New Zealand.

INFORMATION PRIVACY AND MEMBER’S PERSONAL INFORMATION

I agree to the collecting and storing of the personal information supplied. I understand the information can be accessed by club, area association, and by authorised officials when required for Judo/Ju Jitsu purposes only (including for funding / sponsorship applications.)
INDEMNITY
 I understand that Jitsu/Judo is a physically demanding martial art and a full contact sport, and I agree to participate at my own risk. I accept that I am participating on a voluntary basis and I agree to lay no blame on any person or organisation in the event of an accident or injury while undertaking any activities. I understand that in the event of any injury or illness all reasonable steps will be taken to contact my nominated emergency contact person(s), and I agree to allow any injury / illness to be dealt with appropriately.

 

First name:

Last name:

Date of birth:

Gender:

Mobile:

E-mail:

How did you hear about us:
Select class date:
September 2025
September 2025
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