September 22 - 24, 2017
6282 Cranberry Road
Finland, MN 55603
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Billing and Payment
Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*WORLDTANGSOODOASSOC 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

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Registration inquiries:
Ramona Wickstrom
ramona.wickstrom@rangemartialarts.com
Phone:(218) 969-5078
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Waiver and release of all claims must be signed in order to participate

I the undersigned, for myself, my heirs, executors & administrators, do hereby waive, release, & forever discharge any & all rights & claims for damages which I may have or may accrue to me against the World Tang Soo Do Association, the World Ki Gong Club, their respective officers, representatives, successors, officers of the clinic, my own studio, instructor, & their workers &/or assigns & against any participants for any & all damages which may be sustained by me. I will obey all required rules & regulations & also assume full responsibility for any of my actions during & in connection with said event.

I agree that my performance or attendance at the clinic, or both, may be photographed, filmed or otherwise recorded or telecast live & I consent to the use by the World Tang Soo Do Association, the World Ki Gong Club, its assignees & licenses including any public news media of my name, likeness, voice, poses, pictures, & biographical form or language with or without other materials throughout the world without limitation, for television, radio, &/or theatrical motion pictures by any devices now known or hereafter devised & I waive any compensation whatsoever.

By registering for this clinic I understand that the practice of Ki Gong requires time, patience & hard work. I expect to learn healthy application of time tested principles and do not expect diagnosis, treatment or cure of any disease process.
Check this box to indicate that you have read and agree to all of the above terms & conditions