REGISTRATION FORM: RETURN BEFORE JULY 22, 2015 WITH $50 DEPOSIT
MAKE CHECK PAYABLE TO: KUSHI KAI OF COLORADO
THERE WILL BE NO REFUNDS OF DEPOSITS
Name_________________________________________ Age______ M___ F___ Rank: Dan/Kyu ______________________________
Address________________________________________________________________ Dojo___________________________________
City/St/Zip _____________________________________________ Phone_______________ Instructor__________________________
EMAIL_______________________________________
____PLAN 1: 1 NIGHT/2 DAYS
$250 U.S.
____PLAN 2: 2 NIGHTS/3 DAYS
$325 U.S.
____PLAN 3: 3 NIGHTS/4 DAYS
$395 U.S.
ALL UNDER 13 yrs REDUCED
$250 or $25 off
If recd. before July15th deduct $25.*
*Applies to all regular fees. No reduced fees qualify.
READ WAIVER and SIGN BEFORE RETURNING TO
ISKF-COLORADO!
I, the undersigned, voluntarily submit my application to attend the 2015
Mountain States Summer Camp. I release the ISKF and ISKF-CO, UNC,
Martial Arts Academy of Colorado, LLC and all their officers, directors &
guest instructors from all liability and claims against them for any injury,
death, or other circumstances resulting from my participation/stay at said
Camp. I accept full financial obligation for any and all medical,
hospitalization or other costs related to any injury or other circumstances
resulting from my participation or stay at said Camp.
X________________________________________________________________
Signature of participant AND legal guardian, if under 18 years old.
Date______________
Roommate Preferences……….4 people to a rooms
If you have a preference for roommates, please indicate them below.
July 15th
received
FOR
REDUCED
RATE.
$25 OFF
REGULAR
RATE
If you are willing to meet new people, please leave this blank as it will
make it much easier to complete the room arrangements.
received
FOR
REDUCED
RATE.
Roommate Preference (if any):
Roommate1________________________
Roommate2________________________
Roommate3________________________
ROOM RATES ARE HIGHER FOR FEWER
THAN 4 PEOPLE
Mail to:
ISKF-CO
226 S. Broadway
Denver, CO 80209
JULY 22nd
FINAL DEADLINE.
JULY 15th
FOR REDUCED RATE
$25 OFF
REGULAR RATE
July 15th
$25 OFF
REGULAR
RATE
Make checks
payable
to:
Kushi Kai