Competition Form

Please fill in all the Details!

Fields with a * next to them are mandatory, without all these fields your application will not be accepted. Please use a valid email as this is used for your automatic response!

Your Full Name: * Organisation: *
Telephone: Club:
Belt: * Instructor: *
Category: * Instructor Tel No: *
Weight in Kilos: * Address Line 1:
Age: Address Line 2
Gender: * Address Line 3
Expertise: * Postcode:
Date of Birth: * Email: *
BTCB Membership Number: *
Club Number: *
Licence Expiry Date: *
BTC Licence Number: *