Taoist Tai Chi Society of Australia
TOWNSVILLE, 10th September National Workshop Registration Form
Instructions: If paying the deposit at your local branch, please ensure the details, including Transaction Sheet number, are entered below.Please send registration to:
Post:PO Box 3060, Hermit Park QLD 4812, Phone: +61 (0)7 47786956Email:
10th September Nationalworkshop: AUD $60
Name Mr. Ms......
AddressNumber and Street ......
City ...... State ...... Postcode ...... Country ......
TelephoneHome ...... Work ...... Fax ......
E-mail & DOBE-mail ...... Date of Birth ......
ClubBranch...... Region ...... Country (if o’seas) ......
Health ConcernsDo you have any health problems or special requirements (diet, allergies, etc)?
......
EmergencyContact name ...... Telephone ......
TravelArrival date ...... Flight ...... Time ......
From (City of departure, or last connection)……………….…………………….
Departure date ...... Flight ...... Time ......
Airport transport required? At arrival: Yes No At departure: Yes No
Accommodation Billet Motel Not required
Please tick one of the above. If you tick motel, details of motel options can be sent.
(Note: To enable arrangement of billets, a minimum of 4 weeks notice is required.)
Please read and sign: I accept that the Taoist Tai Chi Society of Australia Inc and the local branch ...... hosting the workshop are not responsible for any loss or damage to my personal property, or for any personal injury sustained. I undertake not to teach Taoist Tai Chi™ internal arts of health without the express consent of the National Instruction Coordination Committee of the Taoist Tai Chi Society of Australia Inc. I agree to abide by the by-laws and constitution of the Taoist Tai Chi Society of Australia Inc.
Signature...... Date ......
Payment Advance Deposit: $...... ………
Remaining Workshop fee: $ ………..
Total amount due: $ ………………. Make cheques to: Taoist Tai Chi Society of Australia
I am enclosing cash cheque to the value of $...... with this Form
Office use only...... Amt received $………..Date……….TX no………..Branch………….Amt outstanding $......
(Branch to complete)Amt received $………..Date……….TX no………..Branch………….Amt outstanding $......
Page 1 of 118 January, 1996