Professional Documents
Culture Documents
SEMINAR DETAILS
BRISBANE:
Name
Age
DAN INOSANTO
Address
Work Phone
9:00am to 12:00pm
Sunday 10th December 2006
9:00am to 12:00pm
Mobile
Email
TRAINING EQUIPMENT:
PLEASE TICK:
SYDNEY
SYDNEY
BRISBANE
BRISBANE
CAIRNS
ADELAIDE
Amount Enclosed $
Cash (if paying in person) or
write Cheque or Money Order to V. Vassiliou.
CONTACT DETAILS
www.progressivemartialarts.com.au
www.ninopilla.com
www.progressivemartialarts.com.au
REGISTRATION FORM
SEMINAR DETAILS
BRISBANE:
Name
Age
TH
BIRTHDAY TOUR
DAN INOSANTO
Address
Work Phone
9:00am to 12:00pm
Sunday 10th December 2006
9:00am to 12:00pm
Mobile
Email
TRAINING EQUIPMENT:
PLEASE TICK:
SYDNEY
SYDNEY
BRISBANE
BRISBANE
CAIRNS
ADELAIDE
Amount Enclosed $
Cash (if paying in person) or
write Cheque or Money Order to V. Vassiliou.
CONTACT DETAILS
www.progressivemartialarts.com.au
www.ninopilla.com
www.progressivemartialarts.com.au
TH
BIRTHDAY TOUR
I,
of
(Your name or that of a parent/guardian if under 18years)
(Address)
DO HEREBY ACKNOWLEDGE that of my own free will and desire I
submit my application to participate in the Dan Inosanto Seminar for
instruction and training in martial arts (Jun Fan Gung Fu/Jeet Kune
Do/Maphilindo Silat/Filipino Martial Arts) activities mentioned above and
that I have read and understood the warning in paragraph 5 above.
Signed by the said
(Signature)
In the presence of
(Name of witness)
(Signature of witness)
I,
of
(Your name or that of a parent/guardian if under 18years)
(Address)
DO HEREBY ACKNOWLEDGE that of my own free will and desire I
submit my application to participate in the Dan Inosanto Seminar for
instruction and training in martial arts (Jun Fan Gung Fu/Jeet Kune
Do/Maphilindo Silat/Filipino Martial Arts) activities mentioned above and
that I have read and understood the warning in paragraph 5 above.
Signed by the said
(Signature)
In the presence of
(Name of witness)
(Signature of witness)