Registration Form for Evolutionary Aikido Point Reyes Seminar in Nov 2018

Evolutionary Aikido Point Reyes Seminar

Please fill in the registration form below.
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Telephone with Area Code
Email
Dojo
Rank
If you will be staying in the hostel, please indicate male or female:
Form of Payment - Indicate how you plan to pay
Has the student submitted a completed waiver form?
Payment Information - You can make your PayPal payments, and get information for where to send a check, on this page - https://bodyawakens.com/event/
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