”TAIKIKEN Natural Tuning” week from 24 July till 30 July 2016__€ 545,-
First name: *
Date of birth: *
Home address: *
Postcode & City: *
Gsm / phone nr.: *
E-mail address: *
Skills in martial arts or sports :
Fish is OK
Carpool* - with someone
Carpool - I share my car
I like to pay by BANK For payment use please following bank account:
IBAN: NL67 ABNA 0554 5443 77 name R.J.C. Nansink, Amsterdam;
with description “Taikiken week CZ July 2016 “
By this registration I engage myself to pay € 545,- for the workshop.
I agree to and I accept the payment and cancellation conditions listed above.