Taira Sensei Seminar Adelaide 2019 Registration Form Question Title * 1. Address Name Club/Kai/Kan Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number OK Question Title * 2. Attendance Saturday Sunday Both OK Question Title * 3. Payment by Eft TransferBSB: 082991Acc#: 297487904ACC Name : Joshua SmithPLEASE USE YOUR NAME AS THE REFERENCE/DESCRIPTION/MESSAGEPaid In Full at time of registration Yes No OK Question Title * 4. I hereby submit this application for registration of the above named Masaji Taira Sensei Bunkai Seminar/s. I agree to waive all claims against any persons connected with these seminars/clinics and likewise assume all responsibilities for any injuries sustained, including but not limited to the said seminar and travelling arrangements to and from the said seminar/s.Do you accept these terms? Yes No OK DONE