EmailMe Form - CAF Aikido Summer Camp 2012 Registration Form

Contact Information

Name *

First Last

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Email *

Phone *

### - ### - ####

Emergency Contact Name *

Emergency Contact Phone *

### - ### - ####

Dan/Kyu

Dan

Kyu

Rank

Note: Michael St. Germain is the local Camp Organizer, he can answer your queries or direct you to someone who will have the answers to such topics such as Camp housing and grading paperwork.
Candidates for testing/grading must notify the Camp Organizer at least one week before camp starts, and identify the dan rank for which he/she intends to test. Note that proper paperwork for testing must include written permission of his/her Sensei.

Camp Attendance

Attendance Options & Costs
(Full camp Early Registration $40/Day, or $45/Day after July 31st) *

Full Camp

Partial Camp

Banquet Only

Payment received before 01 June will be considered "Early" registration, with a mat fee of $40/day. Payment received on and after 01 June will be considered "Late" registration, with a mat fee of $50/day.

If You are only attending part of the camp, which days will you be attending?

Aug 30th (Friday)

Aug 31st (Saturday)

Sept 1st (Sunday)

Sept 2nd (Monday)

Banquet

The banquet costs $30 per person, for camp attendees and guests.
Banquet fees are non-refundable.
The banquet will be held the evening of Saturday, Aug 30th.

Banquet - $30 per person (non-refundable)

Yes, I will be attending the Banquet

Number of guests including you.

Special Dietary Needs

None

Vegetarian

Gluten-free

Other

Payment

Participant’s Agreement
Please read the Participant's Agreement or L'Accord De Participant. *

I have read and understood the Participant’s Agreement and I agree to the terms therein

Please mark how you are paying: *

Cheque or Money Order

Pay at Camp

Paypal

NOTE: After submitting the form you will be taken to a page with additional information about your payment type.

Payment at the seminar

(This is the least-preferred option.)

Please bring a printed copy of this form with you when you register and pay on-site.

Would you like a Camp Receipt?

Yes