Date

MM

DD

YYYY

Participant Name *

First Name

Last Name

Guardian (if under 18)

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Seminar Session Registration *

Please check all sessions you would like to register for. NOTE: Schedule subject to change without notice.

Full seminar registration (5 sessions): $275

Friday afternoon: $60

Friday Dinner: $10

Friday evening: $60

Saturday morning: $60

Lunch: $10

Saturday afternoon: $60

Sunday: $60

Will you attend the dinner on Saturday evening? *

Location to be determined at a later date.

Yes

No

Maybe

Payment Method *

Interac e-Transfer to kamusokai@gmail.com

Paypal to kamusokai@gmail.com

Cheque to "Calgary Iaido Club"

Cash (payable at the door)

MEDIA WAIVER *

I hereby grant permission to Ka Muso Kai, its agents and assigns, to use my or my child's photo or video, and likeness for the purpose of promotion by Ka Muso Kai for all forms, media and manners, for the following, but not limited to, news releases, photographs, video, audio, website, marketing, advertising, trade, promotion, and exhibition for an indefinite period of time. I give unrestricted permission for images, videos, and recordings of myself or my child to be used in print, video, digital and internet media. I agree that these images and/or voice recordings may be used for the purposes of promoting Ka Muso Kai and its martial arts and that these images may be used without further notifying me. I further acknowledge that I will not be compensated for these uses and that Ka Muso Kai owns all rights to the images, videos, and recordings, and to any derivative works created from them. I waive any right to inspect the uses of any printed or electronic copy. I hereby release Ka Muso Kai and its agents and assigns from any claims that may arise from these uses, including without limitation claims of defamation or invasion of privacy, or of infringement of moral rights or rights of publicity or copyright.

Yes

No