Bagua Seminar Registration Form .......( Please copy, paste and print this page and email/mail it to [email protected] with your payment, Thank You.

Name:_________________________________________________
Address:_______________________________________________
Age:__________________________________________________
E:mail:_________________________________________________
Contact phone number:__________________________________

Previous Martial Arts experience : Y or N
If so, how long and which Arts:_________________________________
Previous yoga experience: Y or N
If so ho long, which style:_______________________________________
Previous dance experience: Y or N
If so which type:_______________________________________________

What do you wish to gain from this Seminar ? __________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

What to bring:
-Water, snacks, loose comfortable clothing, a towel...
Times: 9:00- 4:00 there will be two fifteen minute breaks and an hour and a half lunch break

COST $300.00 per student

Payment: Please send payments to 1465 Verde Valley School Rd, Sedona AZ 86351 made out to Mind Body Movement Arts, or You can conveniently use the paypal account ( Not yet set up )

Release of liability
Mind Body Movement Arts is merely a service facilitating Master He Jinghan to come and teach his skills to others. It is not run by a single individual thus no single individual can be held responsible for liability for personal property or personal injury. By signing this agreement the participant agrees to release from Liability anyone involved in organizing or demonstrating at Mind Body Movement Arts. If you have health issues it may be wise to consult your physician before participating.

Signature:________________________________________________________________________