Aikido of Santa Cruz 2011 Summer Retreat
Web Registration Form

First name:
Last name:
Gender:
Phone:
Street Address:
Address line 2:
City:
State:
Zip or postal code:
Country:
E-mail address:

Dojo:
Rank in Aikido?
Do you teach Aikido?
In what capacity?

SCHOLARSHIP REQUEST
Download a scholarship application here. I understand that scholarships are available to Aikidoists who are attending the full retreat.   Scholarship applications are due June 1.

SCHOLARSHIP DONATION
Yes! I will help an Aikidoist in financial need participate in the retreat! Please add my donation to the retreat scholarship fund, which is entirely supported by retreat-goers.
Amount: $ (please add the desired amount to your total when making payment)
I would like to reserve a place at the Saturday night banquet in honor of Anno Sensei's 80th birthday and 18 years of the Summer Retreat in Santa Cruz.
The fee is a sliding scale $35 - $60.
Amount: $ (please add this amount to your total when making payment)
I would like a vegetarian option for the banquet.
Payment for the banquet must be received by June 18 to guarantee your reservation.

A simple order-in lunch will be available on Friday served at the Civic. The lunch consists of pinwheel sandwiches from The Buttery (a local bakery), a piece of fruit, a cookie, and a drink.
Vegetarian option. Hummus with cucumbers, avocado, roasted red peppers, and greens.
Meat option. Asian chicken with marinated carrots, green onions, wasabi mustard, and greens.
The cost of the lunch is $10. Please add this amount to your total when making payment if you would like to order the lunch.

I would like to reserve a parking pass.
A limited number of parking passes at the Civic Center are available. The cost is $25 for a five-day pass. Do not pay for the pass now. We will notify you if a pass is available.

Commemorative T-shirts will be for sale at the reateat.
Please help us order appropriately by sharing your preferences:
unisex   women's  
XS   S   M   L   XL   XXL  
short-sleeve   long-sleeve   tank   scoop-neck  

All participants are responsible for arranging their own lodging.


      Registration Prices
(Online payment available through July 4;
after July 4 please register at the door with check/cash)

Full Retreat: ($265 before May 14, $285 after May 14)

Partial Attendance options...   Check all that apply:
Wednesday:   7:00-8:45pm class ($35 before May 14, $40 after May 14)
Thursday:   Full day ($80 before May 14, $85 after May 14)
Friday:   Full day ($80 before May 14, $85 after May 14)
Saturday:   Full day ($80 before May 14, $85 after May 14)
Sunday:   7:00am-8:00am & 10:00am-12:30pm classes ($50 before May 14, $55 after May 14)

Please make note of your total cost for payment either
online or by mail (further information on the next page)
if you have not already submitted payment.
What method do you intend to pay with?


Please Note! That your registration is not complete until your payment is confirmed. The next page has payment options.