Kyoshi Nohara Ryukyukan Seminar

International Ryukyukan Okinawa Karate Kobudo Association

Participant Name:
Dojo:
Instructor:
Age:
Rank:
Phone#:
Address:	(Address City State Zip)

Silvan Dojo Walnut Creek, CA
Saturday, September 13, 2003 2-3:30 pm: Full Contact Seminar	**$20 (only $10 if combined with any other seminar)
Evans Martial Arts Ryukyukan Elk Grove Dojo Elk Grove, CA
Sunday, September 14, 2003 10-11:30pm: Passai Kata Seminar	$20
Sunday, September 14, 2003 12 noon-1:00 pm: Sai Seminar	$20
**All Elk Grove Seminars	$35
Ramtown Karate Ryukyukan Dixon Dojo Dixon, CA
Sunday, September 14,2003 3-4:00 pm: Bo Seminar	$20
Sunday, September 14, 2003 4-6:00pm: Naihanchi and Pinan Kata Seminar	$25
**All Dixon Seminars	$35
**Entire Seminar Package	$60

TOTAL ENCLOSED

MAKE CHECKS PAYABLE TO RAMTOWN KARATE, 628 NORTH FIRST STREET, DIXON,CA 95620 OR EVANS MARTIAL ARTS, 9589 2nd AVE.SUITE B-3, ELK GROVE, CA 95624-1900

I agree to hold harmless Ramtown Karate, Evans Martial Arts, Ryukyukan, and all principles of these organizations in the event of accidental injury or death related to the above seminars. I agree to verify the time and place of the seminars by contacting Ramtown Karate at 707-678-4899, Evans Martial Arts at (916) 685-1933, or the web page at ryukyukan.org after September1 and before September 13, 2003.

Signature:
Date:

Participant signature or legal guardian if under18 years of age.