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TAI CHI
WOMEN'S SELF DEFENSE
CONTACT
SCHEDULE / PRICING
YOUR INSTRUCTOR
PICTURE GALLERY
AFFILIATE SCHOOLS
EVENTS!
PLUM BLOSSOM TAI CHI - AIRDRIE
HOME
TAI CHI
WOMEN'S SELF DEFENSE
CONTACT
SCHEDULE / PRICING
YOUR INSTRUCTOR
PICTURE GALLERY
AFFILIATE SCHOOLS
EVENTS!
PLUM BLOSSOM TAI CHI - AIRDRIE
2013 SPRING TAI CHI RETREAT REGISTRATION
*
Indicates required field
Name
*
First
Last
Gender
*
MALE
FEMALE
Email
*
Phone Number
*
Do You have experience in :
*
Tai Chi / Chi Qong
Fitness/ Weight training/ Yoga
Martial Arts
Method of Payment
*
By Phone using Credit Card-226-927-4569
Email Money Transfer - dsjchantal@yahoo.com
Cash -in person (payment must be taken prior to event-please call)
Emergency contact- (Name/Telephone), Please Include any Physical Limitations:
*
I
do hereby voluntarily submit my application for admission to
The Ontario Plum Blossom Martial Arts Academy for
attendance and participation in lessons
.
Furthermore, I voluntarily consent that any picture furnished by me or any pictures taken of me in connection with
Ontario
Plum Blossom Martial Arts Academy
may be used for publicity and/or promotion of same. Furthermore, I waive the right to any compensation in regard thereto. I understand that there are
NO REFUNDS
for any deposits,fees or tuition paid by me for the classes at
Ontario Plum Blossom Martial Arts Academy
, unless the classes or courses in which I am involved are cancelled or with medical notice from my physician. I also realize that I am responsible for payment in a regular and timely manner.
Submit