2019 4Q Growing Wisdom Workshop Registration
For detailed information, please refer to the main website at http://ZhongShuUSA.org/4Q_MI
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Email *
Name *
Gender *
Phone Number *
Birthday *
Home Address *
Parent/Guardian Information
*Required if under the age of 18
Guardian Name
Guardian E-mail Address
Guardian Phone Number
What are you registering for? *
Special Needs (Allergies, Medications, Dietary Restrictions, etc)
Personal Information (Please specify who introduced you to this camp or enter your Tao Receiving Information) *
No fee for this event; however, the contribution towards class materials and meals are greatly appreciated. If you would like to make a contribution to support this meaningful event, you may write a check payable to "I-Kuan Tao Foundation of America" and mail it to 23845 Middlebelt Rd., Farmington Hills, MI 48336
Electronic Signature
In consideration for the acceptance for participation in or presence at the activity, I hereby waive, release and discharge, the I-Kuan Tao Foundation of America and their members, from and against any and all liability for any loss, personal injury, including death, or property damage that may have arisen out of, or in any way connected with my participation or presence at the event. Even though that liability may have arisen out of negligence or carelessness on the part of the persons or entities mentioned above and herein release.
Furthermore, I assume all responsibility and indemnity the I-Kuan-Tao Foundation of America for any loss, damage or injury to my property, or myself, which may have been caused by negligence, or any act of any person connected in any way with the event. I understand that the I-Kuan-Tao Foundation of America does not guarantee the construction, condition, or safety of the facilities or the equipment and that this Release Agreement is to be binding on heirs, my assigns and me. I have read the above, understand its meaning and voluntarily sign it. Parents or legal guardians must sign for participants under 18 years old.
Sign Below (* temple reserves the right to reject/cancel your registration if space has exceeded) *
A copy of your responses will be emailed to the address you provided.
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