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LBJJF ATHLETE'S APPLICATION FORM:

Name:________________________________________________________
Address:______________________________________________________
City:________________State:________________ Zip code:_____________
Phone:(____) _____-____________ DOB:_______/_____/_______
Email:________________________________________________________
School Name:__________________________________________________
Ranking:______________________________________________________
(Attach your certificate) – White belts or No Gi athletes does not need certificate.
Professor Name:________________________________________________
Professor contact info:___________________________________________
Professor Ranking:______________________________________________

Competitions that you participated in:

 _________________________________
 _________________________________
 _________________________________
 _________________________________
 _________________________________

____________________
Signature

LBJJF - www.lbjjf.com - info@lbjjf.com


45616 university park ave, suite a– Hammond – Louisiana – 70403 –
Phone: 985-605-3169 Fax: 985-520-0830
Pay Pal ellwanger@gmail.com Or write a check to Gracie Barra Northshore
www.paypal.com

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