Formulaire D'inscription Au Registre Des Instructeurs De La Région De L'est
Taoist Tai Chi Society of Canada
NATIONAL SENIORS WEEK 2010
First Time Registration Registration Modification
To place an ‘X’ in a check box, double-click on the box and choose ‘Default Value–Checked’ in the list of options
First Name/ Last Name
/ Female Male
Number and Street:
/ City:
/ Province/ State: / Postal Code/Zip:
/ Country:
Home Telephone:
/ Cell Phone:
/ Email:
Do you have any special requirements? (See also options below.)
/ T-shirt for the National Seniors Week:
Small Medium Large XL XXL
Emergency Contact Name:
/ Emergency Contact Telephone Number:
ARRIVAL AND DEPARTURE
By PLANE at Ottawa International Airport : (Pick up outside across from the taxi area)
Arrival date and time: / Flight No. / Carrier:
Departure date and time: / Flight No. / Carrier:
By TRAIN at Ottawa Tremblay Station: (Pick up outside the main entrance)
Arrival date and time: / Departure date and time:
By BUS at Ottawa Catherine Street Terminal: (Pick up outside near the taxi area)
Arrival date and time: / Departure date and time:
By CAR at Guelph University, Kemptville Campus: (You may park free all week)
Arrival date and time: / Departure date and time:
Please pick me up (Wear a Tai Chi logo) Please drop me off
ACCOMMODATION
Room accommodation includes bedding and towels.
I require a room: Yes No / I will be camping: Tent RV NOTE: No campfires, no cooking, no plug-ins, no dumping stations
Roommate request (These cannot be guaranteed) / First Name: / Last Name:
Notes on my lodging requirements :
MEALS
The cafeteria can accommodate most dietary needs. Please identify your needs below.
I will be present for dinner on Sunday evening (Dinner will be served from 5:00 to 6:30 pm. A cold plate will be available after 6:30.)
I have special dietary needs: Diabetic Celiac Vegetarian Vegan Other please specify:
Notes on my food requirements :
WORKSHOP INFORMATION
Cost: $500 (CAD) – Cash or cheque
The workshop starts on Monday, May 17 at 10 am and finishes on Friday, May 21 at noon at:
Guelph University, Kemptville Campus
830 Prescott Street, Kemptville, Ontario K0G 1J0
Participant's Signature: / Branch: / Date:
Telephone at
Ottawa Branch
613-233-2318 / E-mail Registration
/ Fax Registration
613-233-2327 / Mail Registration
Taoist Tai Chi Society
2930 Carling Ave
Ottawa, Ontario K2B 7J7
Registered by: / Date: / Amount paid: / Transaction number:
Registration is subject to the laws of Ontario.