Registration Form Under 18 Years Name of Child * First Name Last Name Child's date of birth * MM DD YYYY Name of Parent / Guardian * First Name Last Name Contact Number * Emergency contact number * Email * Past / Ongoing health risks or injuries * Does your child have any past experience in Grappling Martial Arts? ( Jiu Jitsu, Judo, Wrestling ) Yes No Purpose behind teaching your child Jiu Jitsu Personal Development Competition Self Defense / Bully Prevention Fitness Other How did you hear about 10th Planet Beirut? NOTE: In case of injury, 10th Planet Beirut & 10th Planet Jiu Jitsu will not be held accountable. * Safety is our number one priority at 10th Planet Beirut, especially when we're dealing with kids.. Jiu Jitsu however is a close contact sport and accidents, although extremely rare, do sometimes happen. Agree Thank you! We have received your registration form and will be in contact with you soon!
