Sign up - LEOS JIU JITSU ACADEMY | Chatan-cho, Okinawa

Personal Details

* Required field

Visitor Member

* First name

Last name

Gender

Phone Number Add secondary Phone +

Secondary Phone

Email Address

Add secondary Email +

Secondary Email Address

Date of birth

* Parent/Guardian's name

Pick a check-in code (4 digits)

Address

Street address

City

Zip / Postal code

State

Country

Contacts

Contact Name

Phone Number

Relation

Additional Contact

Photo

* Required

Capture from camera No camera found. Please connect a camera to use this feature. Upload or use camera Upload photo

Membership

Membership Documents

How did you hear about us?

Who referred the member to us?

More details:

Interface Language

Account Password

Please pick a password to log-in to your account later.

Password (minimum 8 characters)

Confirm Password

Payment

Select membership first

Credit Card All transactions are secure and encrypted

Name on card

Payment Card

Payment will be provided later.

Signup

Personal Details

Address

Contacts

Photo

Edit Photo

Membership

BJJ Membership

Drop In (1DAY)

Drop In (1Week)

Drop In (2 WEEKS)

Drop In (ONE MONTH)

KIDS BJJ (7-12)

Master Membership (BJJ/MMA)

MMA/Striking

Student BJJ (13-18)

Student Master Membership BJJ/MMA (13-18)

Student MMA & Striking (13-18)

Toddlers BJJ (4-6)

Visitors from family gym