Temple Knights Kung Fu & Ninja Camp
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Name: |
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Address: |
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Telephone #: |
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E-mail: |
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Birthdate: |
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mm/dd/yyyy |
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General Health: |
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Special Diet Requirements: |
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Previous Martial Arts Experience: |
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What do you hope to gain from this camp? |
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WAIVER:
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By signing this registration form I certify that the above information is correct. As a participant I acknowledge that the Temple Knights and their representatives shall in no form be liable or responsible for injury or bodily harm occurring to me during classes and that such risks shall be borne by myself voluntarily. |
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SIGNATURE,
or Signature of Guardian
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DATE: _______________ |
| Payment by Cash,
Cheque (payable to Temple Knights) or Visa. P.O. Box 336, Bracebridge, On., P1L 1T7 Ph. Muskoka (705) 767-1177 Fax: (705) 767-1165 tknights@muskoka.com |
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