Ka Muso Kai

4th Annual Summer Seminar Registration Form

August 12th – 15th, 2010

 

Instructions:

 

Please fill out the below form and mail it to Chris Gilham at 9 Coachway Green, SW. Calgary, AB. T3H 1V9.

All fees Payable to Calgary Iaido Club:

 

Name:                                                                                                                                                 

Address:                                                                                                                                             

Town/City:                                                                                                                                         

Province/State, Country:                                                                                                                    

Postal/Zip Code:                                                                                                                                

Phone:                                                                                                                                                

 

Session Basis:

 

Note: If you are registering on a per session basis you must register for the first session of an art to be able to attend the second session.

 

Sessions ($60 per Session)

Session

 

___ Kage Ryu (1) Thursday August 12 (6 – 9 pm)

Please check which Sessions you

___ Kage Ryu (2) Friday August 13 (6 – 9 pm)

would like to attend

___ Jodo (1) Saturday August 14 (9 – 12 pm)

 

___ Jodo (2) Sunday August 15 (1 – 4 pm)

 

___ Niten (1) Saturday August 14 (1 – 4 pm)

 

___ Niten (2) Sunday August 15 ( 9 – 12 pm)

 

 

Total Cost (# Sessions x $60):

__________

           

Art Basis:

 

Arts

Arts

 

___ Kage Ryu

Please check which Art(s) you

___ Jodo

would like to attend

___ Niten

 

 

If you selected 1 Art Total Cost = $110

 

If you selected 2 Arts Total Cost = $220

 

If you selected 3 Arts Total Cost = $300

 

 

 

Total Cost:

__________

 

Total:

 

Payment Included (Please Circle):    Yes        No

Amount of Payment (Total Cost from Above): __________

 

Disclaimer/Waiver (IMPORTANT):

 

I, the undersigned applicant to the Ka Muso Kai Seminar understand that I am applying for instruction in kenjutsu, an activity that involve physical activity. I further understand that the Ka Muso Kai carries no insurance against injury to any of the participants in the seminar.

I hereby acknowledge that I am assuming the risk and responsibility for any and all injuries that I may suffer due to injury, suffered by me, or caused by third parties to me arising out of the practice of Kage Ryu, Niten Ichi Ryu, Jodo, or during the use of any of the facilities available. I further acknowledge that I am responsible for providing my own personal health, medical, dental and accident insurance coverage. I hereby release the Ka Muso Kai and all of its associated persons from liability for any injury or loss suffered by myself.

DATE_______ SIGNATURE ______________________________

PARENT/GUARDIAN (under 18)___________________________