Hanshi Patrick McCarthy Seminar 2010

Registration Form

 

Date: August 13th, 14, 15th

2010

Times:

Friday 6-9pm - Sat 9-4pm - Sun 9-3pm

 

Cost: Fri only $50, Sat or Sun only $80, Sat and Sun $150, All three $175

PLEASE!!! NO VIDEO CAMERAS

Name:

Age:

Address:

City:

Postal Code:

Phone:

E-Mail Address:

Waiver: I hereby submit this application for registration of the above named, for the martial arts seminar hosted by Lopresti's MMA, Shotokan Karate Jutsu, IRKRS, it's instructors / affiliates and Hanshi Patrick McCarthy. I agree to waive all claims against any persons connected with this clinic and likewise assume all responsibilities for any injuries sustained, including but not limited to said seminar and travelling arrangements to and from said seminar.

Signature________________________________ Date_______________________

Mail with payment to: Shotokan KarateJutsu, 284 Delsea Dr., Sewell, NJ, 08080