ASJJA Martial Arts Participation Health History Questionaire

Name:____________________________________________________________________

 

Age: _____ Birth Date: ________________

 

Past and Present Health History (check all that apply)

____ Diseases of the heart and arteries               ____ Abnormal electrocardiogram ECG

____ High Blood pressure                                   ____ Angina pectoris (chest pain)

____ Epilepsy Stroke                                         ____ Anemia

____ Abnormal Chest X-ray Cancer                     ____ Asthma or other lung disease

____ Orthopedic or muscular-skeletal problems    ____ Diabetes

 

If any other prior or pre-existing health conditions please list and explain: _______________________

_________________________________________________________________

_________________________________________________________________

 

If any of the above are checked or listed, please explain and indicate any recommendations your doctor has made regarding exercise: ______________________________________________________________

 

Is there a family history of heart disease, hypertension, stroke, diabetes, lung disease or epilepsy? (Circle one)    Yes     No

 

Any current prescription medications:_____________________________________________________

 

Level of Physical Activity:

 

___ Yes ___ No Are you currently involved in a REGULAR aerobic exercise program?

 

___ Yes ___ No Are you currently involved in a weight training program?

 

___ Yes ___ No Do you regularly perform stretching exercises?

 

What best describes your level of physical activity during the last 4-6 weeks: (Circle one)

 

Very Active        Moderately Active          Occasionally Active        Inactive

ASJJA - FL-041 

Armed Services Judo & Jujitsu Academy

Just a 

"Prevent Child Abduction"

"Mississippi Judo Tny - Oct 23rd"  

 IJF Master Judo Gear Supplier

PENSACOLA, FLORIDA

ASJJA Judo classes sponsored by Sensei Robinson at the Fred Smalley Youth Center, Pensacola, Florida are not currently active. Those active ASJJA students participating at the Fred Smalley Youth Center, Pensacola, Florida, need to contact Sensei Robinson or R.J. Robinson (robin0305@aol.com) for further guidance.  Activities and pertinent information shall continue to be publicized on this website.

AT LARGE

No changes are expected for those At Large (outside Pensacola, Florida) ASJJA Members sponsored by Sensei Robinson. 

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(Pensacola, Florida)

CURRENT MOON

U.S. - International

Kajukembo - MMA

 

 

<<< Martial Arts Timeline for GSM Lasit. >>>

There are five men credited as co-creators of Kajukenbo, and it is from their respective arts that Kajukenbo draws its name. SGM Lasit is a direct decendent of Sijo Adriano Emperado teachings.

KAJUKENBO

KA     Karate: Peter Young
JU     Judo/JJ: Frank Ordonez/Joe Holck
KEN  Adriano Emperado
BO    Boxing (Chinese): Clarence Chang

Philosophical Meaning of Kajukenbo: "Through this fist style one gains long life and happiness."

(Honolulu, Hawaii)

 

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