RBKD Regional Fall Kobujtsu Seminar
Registration Form
San Franciso, CA, September 28 - 29, 2001

Name__________________________________________________   Age________   Tel # (____)___________
Address___________________________________________________________________________________
City_____________________________________________   State______________   Zip__________________
Dojo____________________________________________   Rank____________________________________
Style____________________________________________   Instructor_________________________________

Description Price Door Charge
RBKD Member Saturday (All day)
Saturday (Half day)		 $ 100
$ 55		 $ 15
Non Member Saturday (All day)
Saturday (Half day)		 $ 135
$ 70		 $ 15
Karate Kata Class 1 class $ 35  
Group Lesson Friday $ 30  
RBKD Instructor Dinner Friday night $ 35  

 

 

I am enclosing a check in the amount of: $_______
Please respond by Monday, August, 2001

I, the undersigned,do hereby submit my application for participation and attendance in the Ryuku Bujutsu Doyukai Kobujutsu Seminar and do hereby assume full responsibility for any damages, injuries or losses I may incur, if any, while participating or attending. Ihereby waive all claims against the promoters or sponsors of the semnar, individually or otherwise, for any injuries or losses that I may sustain.

I fully understand that any medical treatment given me will be of a first aid treatment type only. I consent that the sponsors for publicity or promotion can use any pictures or video films taken of me in connection with the RBKD Kobujutsu Seminar, and I waive compensation in regard thereto. I also understand that fees are nonrefundable

Participant or Guardian Signature__________________________________
 

Please make checks payable to RBKD

Mail to:Oshiro's Karate Dojo
917 Main Street
Redwood City, CA 94063
Tel: (650) 364-7653
Fax: (650) 364-1338