Northeastern Tae Kwon Do Academy

TAE KWON DO ACADEMY

NORTHEASTERN

Balance Your PracticeIntroduction to Tai ChiJeanne Donnelly - Makoto-Do4th degree black belt Taekwondo16 years Tai Chi and Qigong experience20 years yoga experienceMaster Level Reiki Certi�cation

Combat SAMBO Street TacticsStreet survival & Restraining techniquesGrandmaster MICHAEL GALPERIN6th degree (highest) Combat SAMBO4th degree black belt Jiu-Jitsu4th degree black belt Judo3rd degree black belt Combat Hapkido

Essential Grappling for StrikersEscapes & Control techniquesMark Capuzziello - CAP MMA20 years of training including BrazilianJiu-Jitsu, Submission Wrestling, Judo,Muay Thai kickboxing, Taekwondo, and Sambo

in association with Makoto-Do, U.S. Combat SAMBO Association, and CAP MMA

Presents

Three Fantastic SeminarsOne Martial-Arts-Filled Day!

Lunch - Sandwiches & Snacks

9:30 am

11:00 am

2:00 pm

1:00 pm

Welcome & Taekwondo Demos9:00 am

Wrap-Up & Taekwondo Demos3:30 pm

NORT

HEASTERN TAE KWON DO ACAD

EMY

1993 2013

Proceeds to benefitthe Norman L. McLindenScholarhip Fund

Saturday October 19th, 2013 9:00 am - 4:00 pmOpen to everyone! - Martial artists and non-practicioners, no experience required!

There hasn’t been a martial arts collaboration like this

since... we can’t remember!

Expand your martial arts training or get introduced to some of the various martial arts styles in the world!

All-Day, All-Inclusive Pass: $45*(includes lunch)

proceeds to benefit theNorman L. McLinden Scholarship Fund

Make checks payable to:Northeastern Tae Kwon Do Academy

Register Early - Space is Limited

for more informationcontact NETKD at(508) 966-3070

orinfo@netkd.net

*USCSA members receive a $10 discount

Please be sure to complete the form on the reverse side of this page and submit it to NETKD or present it on the day of

the seminars.

NORTHEASTERN TAE KWON DO ACADEMY

SEMINAR REGISTRATION FORM AND WAIVER All participants must complete and sign this form before they will be allowed to participate in the

seminar. Please return this form with your payment. Please print all information.

Name:

Age: Email:

Phone:

If you are a current member of a martial arts school, please complete the following section:

School:

Instructor:

Rank:

I understand that martial arts training is a physical, contact activity and that my participation might

result in serious injury, including permanent disability or death. I agree that the staff and instructors of

Northeastern Tae Kwon Do Academy, seminar directors, other participants, and the owner of the

premises, shall not be liable for any loss or injuries I may sustain while participating in the seminar. I am

participating at my own risk. I grant permission, in the event of injury, to have a doctor, nurse, athletic

trainer, or other emergency medical personnel provide me with medical assistance or treatment for

such injury.

I certify that I am 18 years of age or older. If under the age of 18, a Parent or Guardian must

authorize your participation in the seminar.

Participant: Date:

Parent/Guardian: Date:

Make checks payable to: “Northeastern Tae Kwon Do Academy”

Mail to: Northeastern Tae Kwon Do Academy, 15 North Main Street, Bellingham, MA 02019

Seminar fees are not refundable. Please register early, as space is limited. Registration at the door will

be on a first-come, first-serve basis, if space is available.