Kids at Midway Sign-up Form

Child's First Name

Child's Last Name

Date of birth

Age bracket

Guardian Name

Guardian Phone *

Guardian Email *

Martial Arts Experience

Allergy and Medication Notes

Anything the we need to be aware of

Media Consent*

*Sharing the Journey – Media Consent

At Midway Jiu Jitsu, we’re passionate about growing the sport in Mangawhai and celebrating the progress of our members — both kids and adults. As part of that, we love to share moments from our classes, training highlights, and learning milestones through our social media (mainly Instagram: @midwayjiujitsu and our website: midwayjiujitsu.com).

This might include group footage, technique breakdowns, or action shots where students can be seen in the background or featured. We always aim to share content that’s respectful, inspiring, and focused on celebrating effort and growth.

If you’re happy for us to include your child in this kind of content from time to time, please indicate above. We’ll never single anyone out unless it’s with excitement about their progress — and we’re always happy to chat if you have any questions.

I acknowledge that participation in Brazilian Jiu-Jitsu involves physical activity and carries a risk of injury. I agree not to hold Midway Jiu Jitsu or its staff liable for injuries that may occur during classes, provided all safety guidelines are followed.

I give permission for my child to participate in Brazilian Jiu-Jitsu classes at Midway Jiu Jitsu. I confirm that all information provided is accurate.

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