Membership Form - West Coast Jiu-Jitsu

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Student Information

Email *

Name *

Address *

Phone number *

Date of Birth *

YYYY

Gender *

Male

Female

Required

Medication Information / Allergies ( If any ) *

Emergency Contact *

Membership Cost / Pricing

- $195 Monthly unlimited classes - Month to Month
recruitment payment

Registration fee

- $100 (does not include uniform fee)

Starter kit

- $250 ( includes uniform Gi + t-shirt + plus 30min intro class one on one)

Uniform cost

- Adult: $165 (Gi) $50 (rashguard)
- Kids: $135 (Gi) $50 (rashguard)

Family discount (2 or more membership per household)

- 10% off (discount applies to any membership after the first)

Hero discount ( fire/police/law enforcement)

- 10% off

*** Discounts can not be combined ***

*

$195 Monthly unlimited classes - Month to Month recruitment payment

$250 Starters Package (one time fee) (Gi + T-shirt + 30min private class)

$165 Adult uniform (Gi) (one time fee)

$135 Kids uniform (Gi) (one time fee)

$50 Adult/Kids Rashguard (one time fee)

10% off Family discount

10% off Hero discount

Required

By returning completing this form, I agree to my son/daughter/child in my care taking part in the activities of West Coast Jiu-Jitsu. I understand that I will kept informed of these activities, such as class time and details. I understand in the event of injury or illness all reasonable steps will be taken to contact me or an emergency contact listed on this form, and to deal with the injury/illness appropriately *

I agree

Required

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