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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
Submit.
Thank you.
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Full Name (same as Passport/ID)
*
Nationality (same as Passport/ID)
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Email Address
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WhatsApp Number
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M / F
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Age
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Which dates are you registering for?
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Which Course/Retreat you are registering for?
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Why are you attending this Course/Retreat?
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What is your level of experience & skill in Taichi and Qigong?
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What is your level of health & fitness?
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Do you have any health issues?
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I agree to all Terms & Conditions & Disclaimer stated on the following website: https://taichibali.com/terms-conditions/ YES / NO
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Do you have any questions?
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Anything else you would like to share?
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Submit