Note: This form may be printed, then filled out and returned to G.E.Mattson.

Summer of the Tiger, Dragon & Crane:
Martial Arts Festival '99

July 30 - Aug 1, 1999
Massachusetts Maritime Academy
Buzzards Bay, Mass.

Mail completed application and payment to: George Mattson
POB 1867
Brockton, MA 02303

Dear George:
Please enroll me in the 1999 Summer Camp.
Enclosed $_______ for full payment or $______ as partial payment. I am registering for the following program:

Check program of choice.
Full payment must be received by July 10, 1999.

$25 discount, (Daytripper excluded) if full payment received before June 25th.

__1. Thu, Fri, & Sat nights, all meals & linen set. . . . .$299*
__2. Thu, Fri & Sat nights, all meals. No linen. . . . . . .$289*
__3. Fri & Sat nights, all meals & linen set. . . . . . . . . $274*
__4. Fri & Sat nights, all meals. No linen. . . . . . . . . . . $264*
* Deduct $25 for applications paid in full by June 25, 1999

Sorry. . . No discounts apply for Daytripper programs

__5. Full Daytripper. 3 days with lunches. . . . . . . . . . . $150
__6. Single Daytrips with lunch (per day). . . . . . . . . . . $75
[ Check days attending: Fri__Sat__Sun__]

Free T Shirt for full payment Received by June 20, 1999. Check-in on Thursday starts at 6P.M.
Friday check-in begins at 7:00A.M. Check size: Small__ Medium__ Large__ XLarge__

PLEASE PRINT CLEARLY

LAST NAME_____________________________________
FIRST NAME_____________________________ Male___Female___
Street:_________________________________________ City__________________State______________Zip_________________
Age______ Style:______________ Rank_______ Teacher___________________
Roomate Choice:_________________________
Telephone #_______/________/_____________

Method of payment: Master Card__Visa__ Other__ (Postal/Bank Money Order, Drawn on US Bank/Funds)

Credit Card Number:___________________________________________________

Expiration Date:______/_______ Note: Credit card refunds subject to a $25 service charge by bank. No refunds after July 20, 1999.

I agree to release & 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: North American Chapter, its members, Eastern Arts and Humanities Center, Inc. and Summer of the Tiger, Dragon & Crane Martial Arts Festival and all instructors and participants of the 1999 event. 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 or pictures without written permission from George E. Mattson.

________________________
Date

_______________________________________________
Signature / Parent/Guardian

Please duplicate this form for your friends and classmates. Help make the 1999 camp a huge success: