Women’s Wellness Weekend Registration

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Women’s Wellness Weekend RegistrationMelissa Church2022-03-11T20:23:22-05:00

Women's Wellness Weekend Registration Form

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Name

Phone number

E-mail

Mailing Address

Emergency Contact Name and number

Dates to Attend

(Please select all or individual dates.)

Friday, June 17th

Saturday, June 18th

Sunday, June 19th

Would you like single or double occupancy?

Linens

Optional: Would you be interested in a massage during the weekend? Additional charges would apply for the therapist.

Do you have any dietary restrictions or allergies?

Please indicate your general health or any health concerns that we should be made aware of during your stay.

What do you hope to gain from this weekend?

Previous Martial Arts or fitness experience?

How did you find out about about this Women's Wellness Weekend?

Would you like to receive our e-mail newsletter?

Payment

e-transfer (to: info@templeknights.com)

Visa or Mastercard (add 3.4% surcharge)

cash or debit (in-person)

cheque (payable to Temple Knights)

Paypal

Please indicate whether you wish to pay the full amount or a 50% deposit.

payment in full

50% deposit

Waiver: By signing this registration form I certify that the above information is correct. As a participant I acknowledge that Temple Knights and their representatives shall in no form be liable or responsible for injury, bodily harm occurring to me during this weekend and that such risks shall be borne by me voluntarily.

Date (optional)

Signature (optional)

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