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Registration Form
New Student Registration Form
PRIVATE & CONFIDENTIAL
For Tai Chi Bali instructor Dave West only.
Please fill in all the boxes below and
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Thank you.
REGISTRATION FORM
Full Name (same as Passport/ID)
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Nationality (same as Passport/ID)
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M / F
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Age
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Email Address
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WhatsApp Number
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Which dates are you registering for?
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Which Course/Retreat are you registering for?
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What is your level of skill and experience in Taichi & Qigong? Beginner, Intermediate or Advanced?
*
Do you have any health issues?
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Do you have any questions?
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Anything else you would like to share?
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I agree to all Terms & Conditions on this webpage: https://taichibali.com/terms-conditions/ YES/NO
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If you are human, leave this field blank.
Submit