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For Tai Chi Bali instructor Dave West only
Name (same as passport/ID)
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WhatsApp number & country code
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Email
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M / F
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Age
What is the name of the Course/Retreat you are registering for?
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What dates are you registering for?
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What is your level of skill/experience in Taichi & Qigong? Beginner, Intermediate, Advanced?
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What fitness program or health exercise to you practice regularly?
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What is your current state of health? Poor, Average, Good?
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Do you have any health issues?
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Anything else you would like to share that we should know about?
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Do you have any questions?
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I agree NOT to bring my phone or electronic devices to the practice room/area YES/NO?
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I agree NOT to smoke/vape or take illegal drugs/narcotics for the full duration of the Course/Retreat YES/NO?
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I have read and agree to all Terms & Conditions on this webpage: https://taichibali.com/terms-conditions/ YES/NO?
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Your electronic signature (write your Passport number/ID)
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Today’s Date
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