Enrollment First Name *Last Name *Birthdate *Gender *Mobile Number *Email Address *AddressParent or Guardian *Street Address *Suburb *State *Country *Post Code *Program *Please SelectJunior age 5-9Teen age 13-19Adult age 20-99Dojo *Please SelectBooragoonO'ConnorOsborne ParkConsent *Yes, I agree with the privacy policy and terms and conditions. I understand that a minimum or 2 weeks notice in writing is required to make changes and or cancel membership. I the undersigned, in consideration of, and as an acceptance of my entry in this event for myself, my heirs, executors and administrators, hereby waive all and any claims, which I or they might otherwise have, arising out of any loss of life, injury or loss of any description whatsoever, which I may suffer or sustain in the course of or as a consequence of competing in the said event. This waiver, release and discharge shall be in favour of all persons, joint or severally involved in the promoting or staging the event.Total$Credit / Debit Card *Submit FormPlease do not fill in this field.