Grandmaster Chen, Xiao Wang Registration Form
Pre-registration by September 1, 2009. Space is Limited.
Please print and mail this registration form with your cash/check/money order payable to
Kim Ivy
1716 NW Market
Seattle, WA 98107
All money, once paid, is non-refundable.
Name
Address
City, State Zip
Phone Print Clearly Email
Please indicate sessions you wish to attend:
Entire Workshop
September 18-20
$250
  
Laojia per day $110/Silk Reeling $60 $110/$60  
Add $50 for all registrations after Sept. 1 $50  
Total Enclosed. Please remember to make checks to Kim Ivy, checks to Embrace the Moon will be returned and your registration will not be valid.
 
Please indicate your Martial Arts/Tai Chi/Qigong/Yoga/Meditation training, if any, current teacher if applicable & any special health concerns we should know about:

Return to Embrace The Moon Workshops