Application form Czech workshops

Thank you for your interest in our
Martial Art with Feeling workshop - Taikiken advanced in the Czech republic.
Please, help us by filling following details.

I sign-up for:

Personal & Contact information

the fields marked * are required

Special information

Meal requests:*
(more choices)

I will travel with:*
(more choices)

Conditions

Your participation in the workshop will be definitive after we receive your application form
and deposit from you.To avoid disappointment, please apply early!
Cancellation costs: till four weeks before beginning of workshop we will charge 40%,
after that it will be 80% from the indebted amount.

You are adviced to arrange a travel and annulment insurance!

Payment

A deposit of € 200,00 (or 400,- from special offer) have to by paid to secure your reservation for participating in the workshop latest before 27 May 2008.

The rest of the amount should be paid before 18 July 2008.

”TAIKIKEN advanced” in Czech republic from 27.07. - 02.08.2008 ______ 495,- €

”TAIKIKEN Natural Tuning 2”in Czech republic from 03.08. - 09.08.2008__ 495,- €

SPECIAL OFFER: 2 weeks from 27 July to 09 August 2008 _______ 950,- €

+ 1 night accommodation with breakfast between two weeks.

First name:*

Surname:*

Date of birth:*

Address:*

Postcode & City:*

Country:*

Gsm - phone nr.:*

E-mail address:*

Skills in martial arts or sports :

What?Level?

Vegetarian

NO fish

Fish is OK

No restrictions

Train

CAR

Airplane

TAXI

BUS

Other

Carpool - with someone

Carpool - I share my car

NOTES:

I like to pay by BANK (please, send me the bank account number)

I like to pay by PAYPAL (please, send me PayPal request on my email)

By this registration I engage myself to pay € 495,- for the workshop.

I agree to and I accept the payment and cancellation conditions listed above.

Modified on: 28 April 2008