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USA Judo Refugee Application
This submission form is to apply for a one-year USA Judo Refugee status. This designation will allow approved athletes to compete in the
regular Intermediate and Juvenile categories at the USA Judo Junior Olympics competition ONLY
. This designation does NOT allow approved athletes to compete in all point tournaments. Athletes that are approved may also be selected to represent the US at the U13 & U15 Pan American Championships.
All approvals are done by USA Judo's National Office and must be submitted
AT LEAST 48 hours
before online registration for the event ends. Questions may be directed to Austin.Leath@usajudo.us.
The $50 application fee is non-refundable and is charged before document review. Status may be revoked by USA Judo and USA Judo Board of Directors at their discretion.
More information and a list of requirements may be found here:
www.usajudo.com/athletes/juniors/usa-judo-refugee-program
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Athlete Name
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First
Last
Athlete USA Judo Membership #
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Name of person submitting documents
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First
Last
Email
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Phone
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Payment Information
Please list all information for the $50 application fee.
Name on Payment Card
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First
Last
Payment Card Number
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Payment Card Security Code
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Payment Card Expiration
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DD
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YYYY
Billing Zip Code
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By signing this form I authorize USA Judo to charge my payment card a $50 non-refundable fee for this athlete’s refugee application.
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