Become our Member - Irish Judo Association

First Name of Member*
First
Surname of Member*
Last
Address*
Street Address Address Line 2 City County ZIP / Postal Code
Date of Birth*
DD dash MM dash YYYY
Gender*
- Male
- Female
Photo
Accepted file types: jpg, Max. file size: 3 MB.
(please supply for inclusion on Licence - head shot only plain background - JPG files only)
Phone*
Mobile No:
Email*

Under 18's Parent/Guardian Section
The section below to be completed by Parent/Guardian if applicant is under 18 years of age.
Parent/Guardian's Name
First Last
Parent/Guardian's Email
Parent/Guardian's Phone
- I wish not to be contacted by email
To be completed by Applicant / Parent / Guardian
To be completed by Applicant / Parent / Guardian
Declaration*
- I agree to the declaration & consent
Declaration: I certify that to the best of my knowledge & belief the foregoing details are correct. I undertake to abide by the constitution & Bye-Laws of the Irish Judo Association together with any amendments that may be made during my period of membership. Please note the policy of ‘No Licence - No Insurance - No Judo’ is in force & cost of personal accident insurance is included in the above categories. I further confirm that I am not a member of any other Judo Federation. I will adhere to the Irish Anti-Doping rules. Consent: Personal information gathered from memberships are used for the sole purpose of promoting the sport of judo. This information may be used to keep clubs/parents/guardians up to date with events, offers and general information regarding regulation and promotion of Judo. Direct Marketing is not undertaken by the Association. Personal Data is handled in accordance with the requirements of the GDPR. Privacy Statement is available at www.irishjudoassociation.ie
Annual Membership Payment
Total
Credit Card*
Card Details
Cardholder Name

Membership