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Organization: IJJOR Jujutsu Onkochishin Ryu - RKAF Ryukyu Kobudo Austria Federation www.jujutsu-onkochishinryu.com www.kobudo-rkaf.com
Place: Francisco Josephinum - Schloss Weinzierl 1 A-3250 Wieselburg Tel. +43 7416 52437 0 Fax. +43 7416 52437 49 Austria
Arrival: Sunday, July 17, 2011 Check-in from 15:00
Departure: Saturday, July 23, 2011 – Check out until 09:00 a.m Total cost (including full board residential and training)Total cost (including full board residential and training)Total cost (including full board residential and training)Total cost (including full board residential and training)
Adults (Age 18+) Euro 340,-- Adolescents (Age 14 - 17) Euro 325,-- Children (Age 6 - 13) Euro 300,-- Escort Euro 280.- Applications are possible until June 15, 2011. When the bank transfer can be confirmed the registration will be completed.
Entry form and confirmation of payment are to be sent to: Franz Gschlad [email protected] Subject for transfer: IV. Sommercamp -Wieselburg 2011 Austria
Bank dataBank dataBank dataBank data: Bank Raiffeisenkasse Michelhausen Bank Account Nr: 879 395 BLC: 32497 IBAN: AT 343249700000879395 BIC/SWIFT Code: RLNWATW1497
Course trainers: Belgium Johny Lenskens - Hakko Ryu Jujutsu Hanshi Italy Roberto De Ronzi - Jiu Jitsu Shihan Italy Jino Nosi Karate - Shito Ryu Shihan
Germany Wolfgang Siebel ( Honorary Master ) Karate Shoto KanShihan Spain Vicente Borondo - Jodo y Kenjutsu Shomokuroku Spain Marcos Sala Ivars - Seitei Iaido Sensei
Switzerland Ralph Irminge - Penka Siltat Haka Tahir Sensei Austria Maria Schmöllerl - Goshindo Spain David Rodriguez – Kobudo Okinawa Austria/Spain Jesus Potrero - Jujutsu/ Kobudo Shihan
Couser instructors:
President: Jesus Potrero Coordination: Haas Harald und Franz Gschlad Medical attendance: Dr. Claudia Prenner Child care: Maria Ellinger Brigitte Horner: Gimnastics
Organization: TDKM – ROBERTO DE RONZI www.jujutsu-onkochishinryu.com www.kobudo-rkaf.com
Place: Francisco Josephinum - Schloss Weinzierl 1 A-3250 Wieselburg Tel. +43 7416 52437 0 Fax. +43 7416 52437 49 Austria
Arrival: Sunday, July 17, 2011 Check-in from 15:00
Departure: Saturday, July 23, 2011 – Check out until 09:00 a.m Total cost (including full board residential and training)Total cost (including full board residential and training)Total cost (including full board residential and training)Total cost (including full board residential and training)
Course TDKM Euro 400,-- Full board Euro 300,-- Course + Full board Euro 675,-- Escort Euro 300.- Applications are possible until June 15, 2011. When the bank transfer can be confirmed the registration will be completed.
Entry form and confirmation of payment are to be sent to: Franz Gschlad [email protected]
Subject for transfer: I. COURSE TDKM -Wieselburg 2011 Austria
Bank dataBank dataBank dataBank data: Bank Raiffeisenkasse Michelhausen Bank Account Nr: 879 395 BLC: 32497 IBAN: AT 343249700000879395 BIC/SWIFT Code: RLNWATW1497
Course trainers: Itali Roberto De Ronzi
Acceptance of parents or guardians
Consent Form
Name of parents or guardians: _______________________________________________ Name of participating minor: ________________________________________________ ____________________________________________________________________________________
I agree that my son/my daughter will participate in IV. International Sommercamp 2011 Wieselburg – Austria which is organized by Ryukyu Kobudo Austria Federation and Ju-Jutsu Onkochishin Ryu from 17th July – 23th July 2011 at
Francisco Josephinum - Schloss Weinzierl 1 A-3250 Wieselburg
Tel. +43 7416 52437 0 Fax. +43 7416 52437 49 Austria
All pictures and videos which are made of my son/my daughter during the course can be used for non- commercial purposes. I confirm that my son/my daughter has no illness or allergies which exclude him/her from a normal participation in the course. .
______________________________________ ________________________________________ Date, Place Signature of parents or guardians
Confidential data of the participant
Data will be treated confidentially. The information is for the kitchen crew in case of special diets, for medical
purpose in case of emergencies and for the course instructors.
Vaccinations: __________________________________________________________________________
______________________________________________________________________________________
Allergies against medicaments, insect bites, food or others? YES G NO G
Please list the allergies with symptoms and required medical treatment (medicaments): _______________________________________________________________________________________
_______________________________________________________________________________________ _______________________________________________________________________________________
Do you need any special medication or are you in medical treatment? YES G NO G
If YES, which one? ________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________
In which interval and dose do you need the medicaments? _________________________________________ ________________________________________________________________________________________ Which reactions could appear? _______________________________________________________________
________________________________________________________________________________________ ________________________________________________________________________________________
Do you want vegetarian food? YES G NO G Do you need a special diet? YES G NO G
If YES, which one? ________________________________________________________________________ Which reactions could occur? _______________________________________________________________
____________________________ ___________________________________________________________ Date, Place Signature of participant or parents or guardians
Contact in case of emergency
Parents or guardians:
Name:____________________________________________________
Address:__________________________________________________________________________
_____________________________________________________________________________________
Phone nr. (Home) ______________ Phone nr. (Work) _______________ Mobile phone nr. _________
Doctor or hospital which should be contacted:
Name:____________________________________________________________
Address:_____________________________________________________________________________
Phone Nr. 1.________________________________Phone Nr. 2.____________________________________
Others:
1. Name.__________________________________ Phone Nr._____________________________________
2. Name.__________________________________ Phone Nr._____________________________________
3. Name.__________________________________ Phone Nr._____________________________________
Date, Place Signature of parents or guardians
Entry formEntry formEntry formEntry form
Course: G IV. Internationale Summer Camp Wieselburg 2011 - G TDKM Assitant Instructor Class -A-
Name:
Street:
Postal code: Place:____________________ Country: Phone Nr.: Date of birth:
E-Mail.:
Association or club: I practise:
GJu-Jitsu GKarate GKobudo GJudo GAikido GKrav Maga GPenka Siltat GJodo GIaido GOthers; _________________________________________________
Weapons, as far as available, please take
Which are required waffen; GJo stick 1,27cm GBokken GTanto GIaito or Katana. Kobudo weapons: G Bo G Nunchaku G Tunfa G Sai
G Yes, I want to go to Wieselburg and back to Vienna by bus. Extra costs Euro per person G There and Return: Euro 40,-- G To route: Euro 25,--
G No, I don’t need the bus transfer
________________________ _________________________ Signature of participant Signature of parents or guardians
Deadline: 15th June 2011 Attention: Limited number of participants
Entry form and confirmation of payment are to be sent to: Franz Gschlad [email protected]
Subject for transfer: IV. Sommercamp -Wieselburg 2011 Austria
Bank dataBank dataBank dataBank data: Bank Raiffeisenkasse Michelhausen
Bank Account Nr: 879 395 BLC: 32497
IBAN: AT 343249700000879395 BIC/SWIFT Code: RLNWATW1497
Reason for transfer: IV. Sommercamp -Wieselburg 2011 Austria
I. TDKM Assistent Instructor Classe A
Map of wieselburgMap of wieselburgMap of wieselburgMap of wieselburg .
Highway A1 – Exit E60 , B25 towards “Wieselburg”. After the main square „Hauptplatz Wieselburg“ take the Grestner Straße towards Weinzierl. In Weinzierl go towards Wechlinger Straße. The parking place is near the main entrance of Francisco Josephinum. Inside there will be direction signs.