User Registration

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User Registration

Fields marked with an asterisk (*) are required.

User Details

First name*
Last name*
Username*
Email*
New Password*
Verify Password*

Additional information

Name of Institution*

Institution Address*

Country*

State*

Occupation

Time set*

Zip*

Athlete Affiliation of Institution*

Other Affiliation

All Judo program affiliations within your institution

Club Sports

Recreation

Physical Education

Athletics

Check all that apply

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INSTITUTIONAL REPRESENTATIVES

Name of Coach

First*

Last*

Representative Address*
Maximum 200 characters

Phone*

E-mail

I am an authorized representative of the institution listed above, do hereby petition the members of the US National Collegiate Judo Association for acceptance into the organization. I further pledge to recognize the US National Collegiate Judo Association as the sole representative of collegiate Judo in the United States and support the Constitution and By-laws of the US National Collegiate Judo Association.

Authorization*

I concur

Check the box to confirm

Please enter the value from the image