Child's Name

Date of Birth

Primary Class

Class Time

Parent/Guardian's Name

Parent/Guardian's Mobile Number

Parent/Guardian's email

Emergency Contact Number

Does your child suffer from any medical conditions we should be aware of? YES/NO?
If YES please provide details:

Do you give consent to Edinburgh Judo taking photos or video of your child to be used on Edinburgh Social media (no child is named)

YESNO

CLASS FEE

TERM £76.50