ITA Summer Payment Form (New)
Name
Name
*
First
Middle
Last
Phone
Phone
*
-
###
-
###
####
Email
*
Are you currently a middle school, high school,
college/university or graduate school student?
*
Are you currently a middle school, high school,
college/university or graduate school student?
Yes
No
Please choose one option.
(Note: a small fee has been added to cover PayPal cost)
Standard Pricing (Select Full Weekend OR just the days you will be attending)
Please note: $5.00 has been added to anyone attending Friday to cover the cost of lunch.
Standard Pricing (Select Full Weekend OR just the days you will be attending)
Please note: $5.00 has been added to anyone attending Friday to cover the cost of lunch.
Full Weekend ($185) (Thurs-Sun)
Friday ($95)
Saturday ($90)
Sunday ($50)
Student Pricing (Select Full Weekend OR just the days you will be attending)
Please note: $5.00 has been added to anyone attending Friday to cover the cost of lunch.
Student Pricing (Select Full Weekend OR just the days you will be attending)
Please note: $5.00 has been added to anyone attending Friday to cover the cost of lunch.
Full Weekend ($135) (Thurs-Sun)
Friday ($75)
Saturday ($70)
Sunday ($40)
Will you be attending Saturday's Banquet?
Will you be attending Saturday's Banquet?
Yes ($20)
No, I will not be attending the banquet
Will you be attending Saturday's Banquet?
Will you be attending Saturday's Banquet?
Yes ($15)
No, I will not be attending the banquet
Would you like a seminar T-Shirt?
(T-Shirts are $25 each and must be pre-ordered)
Would you like a seminar T-Shirt?
(T-Shirts are $25 each and must be pre-ordered)
Yes!
No thanks
Please enter the quantity of the sizes you would like to pre-order...
Qty
Size(s)
Shirt Price
$
Dollars
.
Cents
CANCELLATION/REFUND POLICY
We understand that at times unexpected circumstances arise requiring cancellation. If we receive your cancellation request via email 24 hours prior to Seminar start we will happily refund your seminar enrollment fee minus any transaction fees. However, we cannot refund for meals and T-shirts as they are pre-purchased in advance. Thank you for your support and understanding.
[OPTIONAL]
Donate to Shushinkan today.
A world class dojo requires world class support.
Your voluntary donation is appreciated and contributes to the building fund, operations and maintenance so we can continue to make this world class dojo available to you!
Donation Amount
$
Dollars
.
Cents
$
0
Total
+Tax 3%