I hereby authorise all hospitals, physicians, and all other persons from whom I have received treatment or examination to disclose to the Centre or its representatives all information pertaining to my illnesses or injuries, medical history, consultations, prescriptions or treatments as well as providing copies of all my medical or hospital records. A copy of this authorisation is to be deemed as valid and legitimate as the original signed document.

I wish to be considered for admission or readmission in the National Centre. I declare that all the information presented on this application form is exact and complete. I declare that I have read the NTC GUIDE and will respect all conditions. I understand that Judo Canada reserves the right to modify or reverse any decision on the subject of my admission if any of the above information is inexact or incomplete. This application will not be accepted if any element remains inexact or incomplete. Je souhaite être considéré pour l’admission ou la réadmission au Centre national. Je déclare avoir pris connaissance du GUIDE NTC et en respecter toutes les conditions. Je déclare que toutes les informations présentées sur ce formulaire de candidature sont exactes et complètes. Je comprends que Judo Canada se réserve le droit de modifier ou d’annuler toute décision au sujet de mon admission si l’une des informations ci-dessus est inexacte ou incomplète. Cette candidature ne sera pas acceptée si un élément reste inexact ou incomplet.