Emergency Form BJJ Rotterdam

BJJ Rotterdam emergency form

Personal information

(e.g. name partner / parent / friend)
(full name and telephone number of the attending physician)
(e.g. old injuries, operations or other limitations)


The entered data will be stored offline and removed from the online database. The information will only be used for purposes related to BJJ Rotterdam. Your data will only be provided to the emergency department or attending physician in extreme emergency. Filling in the form is safe and the website is secured with an SSL protocol.