seminar - wordpress.com · 2016. 1. 22. · seminar registration form: yanagi dojo, september, 2016...

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September 16 - 18, 2016 Hosted by: Yanagi Dojo www.aikidonorwalk.com 16 Commerce Street Norwalk, CT 06851 phone: 203-216-4877 Lodging Suggestions: The Marriott, Nowalk, CT (203) 849-9111 Clarion/Doubletree, Norwalk, CT (203) 853-3477 Norwalk Inn, Norwalk, CT (800) 303-0808 Please bring a jo, bokken, zabuton, and zafu if you own them. Friday, September 16 5:15pm-6:00pm Registration 6:00pm-9:00pm Aikido Saturday, September 17 9:00am-9:45am Zazen 10:00am-1:00pm Aikido 3:00pm-6:00pm Aikido 7:00pm Group Dinner Sunday, September 18 9:00am-9:45am Zazen 10:00am-1:00pm Aikido Zenshinkai Aikido Association 601 50th St. SE, Charleston, WV 25304 www.zenshinkai.org Email: [email protected] Ph: (304) 389-7242 About Greg Tetsuzan Noble Sensei: Greg Tetsuzan Noble Sensei is the Chief Instructor for Zenshinkai Aikido Association. He began his Aikido training at the early age of fifteen, and is now ranked Rokudan (6th degree black belt) Aikikai. He also holds black belt ranks in Muso Jikiden Eishin-ryu Iaido and Shindo Muso-ryu Jodo, and has long-term formal training in Zen. Noble Sensei is a certified Zen Teacher and Roshi under Zen Garland, an international organization for Zen training, and is Dharma Successor of Paul Genki Kahn Roshi. About The Hosting Dojo: The word “yanagi” means ‘willow’ in Japanese. The willow is a common icon in Japanese culture; from stories and legends to paintings and poetry. We have adopted the name “Yanagi Aikido Dojo” as a constant reminder of the aim of our training: Grounded, harmonious, sheltering, and graceful. AIKIDO SEMINAR Instruction by: Greg Tetsuzan Noble Sensei, 6th Dan Aikikai, ZAA Chief Instructor

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Page 1: SEMINAR - WordPress.com · 2016. 1. 22. · SEMINAR REGISTRATION FORM: Yanagi Dojo, September, 2016 SEMINAR FEE: $95* Members of Zenshinkai Aikido Association *This seminar is open

September 16 - 18, 2016Hosted by: Yanagi Dojo www.aikidonorwalk.com 16 Commerce Street Norwalk, CT 06851 phone: 203-216-4877

Lodging Suggestions:

The Marriott, Nowalk, CT (203) 849-9111Clarion/Doubletree, Norwalk, CT (203) 853-3477Norwalk Inn, Norwalk, CT (800) 303-0808

Please bring a jo, bokken, zabuton, and zafu if you own them.

Friday, September 16 5:15pm-6:00pm Registration

6:00pm-9:00pm Aikido

Saturday, September 17 9:00am-9:45am Zazen

10:00am-1:00pm Aikido

3:00pm-6:00pm Aikido

7:00pm Group Dinner

Sunday, September 18 9:00am-9:45am Zazen

10:00am-1:00pm Aikido

Zenshinkai Aikido Association 601 50th St. SE, Charleston, WV 25304 www.zenshinkai.org Email: [email protected] Ph: (304) 389-7242

About Greg Tetsuzan Noble Sensei:

Greg Tetsuzan Noble Sensei is the Chief Instructor for Zenshinkai Aikido Association. He began his Aikido training at the early age of fifteen, and is now ranked Rokudan (6th degree black belt) Aikikai. He also holds black belt ranks in Muso Jikiden Eishin-ryu Iaido and Shindo Muso-ryu Jodo, and has long-term formal training in Zen. Noble Sensei is a certified Zen Teacher and Roshi under Zen Garland, an international organization for Zen training, and is Dharma Successor of Paul Genki Kahn Roshi.

About The Hosting Dojo:

The word “yanagi” means ‘willow’ in Japanese. The willow is a common icon in Japanese culture; from stories and legends to paintings and poetry. We have adopted the name “Yanagi Aikido Dojo” as a constant reminder of the aim of our training: Grounded, harmonious, sheltering, and graceful.

AIKIDO SEMINAR

Instruction by: Greg Tetsuzan Noble Sensei, 6th Dan Aikikai, ZAA Chief Instructor

Page 2: SEMINAR - WordPress.com · 2016. 1. 22. · SEMINAR REGISTRATION FORM: Yanagi Dojo, September, 2016 SEMINAR FEE: $95* Members of Zenshinkai Aikido Association *This seminar is open

I would like to register for this seminar.

Please find my payment in the method and amount of (check one):

Cash. Amount: $______.

Check. Amount: $______. Check #______. Make check payable to Zenshinkai Aikido Association.

Paypal. Amount: $______. Send Paypal payments to [email protected]. Do not send to [email protected]. Specify seminar dates with Paypal payment.

Credit Card. Amount: $______.

Type: VISA MASTERCARD

Card #:___________________________ Expiration: _______ CVC #: _______.

Event Dates: _____________________________ Today’s Date: _________________

Name: _______________________________________________________________

Mailing Address: ____________________________________________________________________________________ (address) (city) (state) (zip)

Home Phone: __________________ Work Phone: __________________ Email: ________________________________

Martial Art (check one): Aikido Other __________________________

Name of Dojo: _______________________________________ Rank: _________________

Emergency Contact: ________________________________ Emergency Contact’s Phone: ________________________

Release of Liability (Please read before you sign) For the permission of Zenshinkai Aikido Association and Aikido of Norwalk, to use its facilities and of the execution by others of agreements similar, the undersigned agrees that while upon the premises of Zenshinkai Aikido Association and Aikido of Norwalk or while using its facilities or equipment, whether at Zenshinkai Aikido Association and Aikido of Norwalk or at any other location for the purpose of practice or of demonstration, said premises, facilities, and equipment shall be occupied and used at the sole risk and responsibility of the undersigned, and the undersigned hereby releases Zenshinkai Aikido Association and Aikido of Norwalk from any and all claims for personal injury, damage, or loss of any kind or description resulting from being thereon or from such use or from the acts of any persons thereon. The under-signed further agrees to indemnify and hold harmless Zenshinkai Aikido Association and Aikido of Norwalk and each of its insructors, teachers, officers, directors, and members from or against any and all claims made or instituted against it or them arising out of the acts of the undersigned while upon the promises of Zenshinkai Aikido Association and Aikido of Norwalk or while using any of its facilities or equipment, whether at the Zenshinkai Aikido Association and Aikido of Norwalk or any other location for the purpose of practice or demonstra-tion, including injury or loss to the undersigned however caused and injury or loss caused by the undersigned to any other person. I certify by my signature that I have read and understand this agreement in its entirety and all of my questions regarding it have been fully answered. I understand that Zenshinkai Aikido Association and Aikido of Norwalk documents activities and events involving classes and instruction. I give Zenshinkai Aikido Association and Aikido of Norwalk permission to use any documentation, such as video taping, photography, or film, in which my image is taken in whatever way Zenshinkai Aikido Association and Aikido of Norwalk wishes. I understand that Zenshinkai Aikido Association and Aikido of Norwalk are the sole owner of the documentation.

Signed: ____________________________________ Signed: ______________________________________________ (Parent or guardian if participant is under 18)

Zenshinkai Aikido Association 601 50th St. SE, Charleston, WV 25304 www.zenshinkai.org Email: [email protected] Ph: (304) 389-7242

SEMINAR REGISTRATION FORM: Yanagi Dojo, September, 2016

SEMINAR FEE:

$95* Members of Zenshinkai Aikido Association

*This seminar is open to everyone, regardless of affiliation. Please inquire about our visitor rates at [email protected].