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* 1. Address

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* 2. Attendance

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* 3. Payment by Eft Transfer
BSB: 082991
Acc#: 297487904
ACC Name : Joshua Smith
PLEASE USE YOUR NAME AS THE REFERENCE/DESCRIPTION/MESSAGE

Paid In Full at time of registration

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* 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?

T