Application form Taikiken in NL

Thank you for your interest in our MARTRIX Taikiken training sessions in the Netherlands.
To register, please fill in following form.

Here by, I register myself as participant to Taikiken training in:

Modified on: 13 May 2013

AMSTERDAM - autumn 2013..... €

First name:

Surname:

Date of birth:

Street & home nr:

Postcode:

City:

Gsm / phone:

E-mail address:

Payment:

I will pay via bank transfer

Please, send me the bank account information.

I will pay CASH before first session.

Skills in martial arts or sports :

What?Level?

Notes:

By this registration I engage myself to pay before beginning of the workshop.

voor inschrijving in Nederlands, klik hier a.u.b.