Please note: Although it is most unlikely that you will experience any problems responding to this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may email your response to this form to: George Mattson
Dear George: Please enroll me in the 1998 Martial Arts Festival, to be held at the Mass Maritime Academy in Bourne, Mass. (A free Summer Camp Tshirt will be given to anyone who is fully paid-up by July 1st, 1999.) A $25 discount, (Daytrippers excluded) if full payment received before June 25, 1999.
Please complete the following form.
Mail funds to: George E. Mattson POB 1867 Brockton, MA 02303 or complete credit
card information at bottom of this form. (Or Fax to 508-559-8913 or call credit card info
to 508-586-3969)
Firstname:
Lastname:
Address:
City:
State:
Country:
Zipcode:
Telphone:
Age:
Rank:
Style:
Teacher:
Select one camp option from this group:
*note: Discounts will be automatically issued to all programs (except daytrippers) paying by credit card.
Free T-shirt for full payment received by June 20, 1999.
Select the karate activity you would like to participate in at the camp. You may
select as many as you wish. This information will help us plan and coordinate the camp's
schedule.
Sanchin
Konshiwa
Kanshu
Seiching
Seisan
Seiryu
Konchin
Sanseiryu
Superempi
Kyu kumite
Dan kumite
sparring drills
tournament
strategy
Grappling/ground
work
Pressure points
Healing arts
Multiple items may be chosen.
Select the weapon/s you would like to practice or learn at the camp. All
students must provide their own weapons.
Bo
Sai
Nunchaku
Tonfa
Kama
Kai_(Oar)
Other
Multiple items may be chosen.
Comments & Suggestions for the camp:
I agree to release and waive any and all rights, claims, or actions that I, my heirs, successors, or assigns may have against George e. Mattson, Susan E. Sussman, Uechi-ryu Karate Association and the North American Chapter, its members and Summer of the Tiger, Dragon & Crane Martial Arts Festival and Eastern Arts & Humanities Center, Inc.. I agree to waive any compensation, whatsoever, for the use of pictures, videotape, media coverage, statements, interviews, etc. utilized by those producing this camp. I agree not to take any videotapes without written permission from George E. Mattson. By submitting this form, I agree to these conditions of participation. Thank You.
If you feel uncomfortable about emailing your credit card information, you may phone us and leave the information, request on this form that we call you to obtain it, or you may fax the information to us at 508-559-8913
Select Credit Card to be used
VISA
MASTER CARD
Name on Card:
Credit Card Number:
Expiration: Note: Credit card refunds subject to a $25 service charge by bank. No refunds after July 20, 1999.