Please fill out the form below and one of our team will contact you shortly. When would you like you child to start classes*As soon as possiableAt the beginning od next termAfter a specific dateI would like my child to start Judo classes after the below date* Date Format: DD slash MM slash YYYY Name of Child* First Last What is their current age?*Date of Birth* Date Format: DD slash MM slash YYYY Home Address* Street Address Address Line 2 City ZIP / Postal Code If more than one home use the adress of the place child lives most of the time and where you would like to receive any correspondence.Parent/Guardian DetailsName First Last Home PhoneMobile Phone*Work PhoneEmail Add another parent/guardian I would like to add another parent/guardian Name First Last Home PhoneMobile PhoneWork PhoneEmail Additional InfoPlease list any special behaviours/medical conditions/injuries/medications to be administered, or anything else you believe our Sensei should be aware of:We will most likely call you to discuss any needs further.I/we give permission for our child(ren) to have their photo and name to be used in any marketing and or publicity media like Westsides website, newspaper articles etc.*YesNoPlease contact me on a case by case basis