national seniors week 2014! - Western Region, Taoist Tai Chi

Fung%Loy%Kok%Taoist%Tai%Chi™%%/%Fung%Loy%Kok%Tai%chi%taoïsteMC%
National%Seniors%Week%2014%/%La%Semaine%nationale%des%aînés%2014!
!Please!complete!this!form!with!black!ink!only!!/%!SVP!complétez!a!l’encre!noir.!▹!
!First!Time!Registration/Première!inscription! !Registration!Modification/Modification!d’une!inscription!
!
First!Name/%Prénom!
!
Last!Name/%Nom!de!famille!
!
Number!and!Street!/Numéro!civique!et!
nom!de!la!rue!
!
!!
Home!Telephone/%Téléphone!à!la!maison!
City/%Ville!
!
!
!
Sex/Sexe!
!
Province!
!
Cell!Phone/%Téléphone!cellulaire!!
!
Postal!Code/Code!
postal!
!
!!
EMMail/%Courriel!:!
Country/%Pays!
!
!
!
Date!of!Birth!/!Date!de!naissance!
Special!Requirements!/!Besoins!
TMShirt!Size!/!Taille!de!tMshirt!
/
/
!
spéciaux!
!
S/P! !M! !L/G! !!XL/XG! !!XXL/XXG!
Emergency!Contact!Name!&!Number/%Nom!de!la!personne!et!numéro!de!téléphone!à!contacter!en!cas!d’urgence!!
%
!
Arrivals%and%Departures%I%Arrivées%et%départs%
!Drop!Me!Off/!me!déposer!
!Pick!Me!Up!(wear!a!Tai!Chi!logo/!me!prendre!(porter!logo!de!Tai!Chi)!!!!!!!!!
◊!!By!PLANE%at!Calgary!International!Airport!!!!!!/!!!En!AVION%à!l’Aéroport!international!de!Calgary!
!!!!(Pick!up!Outside!the!Arrival!door!!!/!!Participants!seront!ramassés!à!l’exterieur!de!l’aire!d’acceuil!au!niveau!des!arrivées)!
Arrival!Date!and!Time!/!Date!et!heure!d’arrivée:!
!
/
, 2014
!
Carrier!/!Transporteur:!
Flight!Number!/!Vol!no.!!
!
Departure!Date!and!Time!/!Date!et!heure!de!départ:!
!
/
, 2014
Carrier!/!Transporteur:!
Flight!Number!/!Vol!no.!!
!
!
!
◊!!By!BUS%at!CALGARY!GREYHOUND!TERMINAL!/!En!AUTOBUS%à!l!CALGARY!TERMINAL!GREYHOUND!!
!(Pickup!will!be!outside!of!the!station.!/!Participants!seront!ramassés!à!l’exterieur!de!la!station,!veuillez!chercher!le!logo!de!Tai!Chi.)!
Arrival!Date!and!Time!/!Date!et!heure!d’arrivée!:!!
Departure!Date!and!Time!/!Date!et!heure!de!départ!:!!
!
/
, 2014
!
!
/
, 2014
!
◊!!!!I!will!be!travelling!By!CAR%to!University!of!Calgary!/!En!AUTO!à!l’Université!de!Calgary!!
!!!!!!!Parking!costs!approximately!$8!per!day!!!!!!!!!!!!!!!!!/!!Stationnement!au!coût!d'environ!$8!par!jour!
Accommodation%I%Hébergement!
I!require!a!room!/!Je!veux!une!chambre!!!!!!
!!!Yes!/!Oui!!!!!!!!!!!!
!!!!No!/!Non!!!!!!!!!!!
!
!!!
!!
Room!accommodation!includes!bedding!and!towels!/!!L’hébergement!dans!les!chambres!inclut!la!literie!et!les!serviettes.!
!
!!!Cost!includes!double!occupancy!in!a!dorm!style!room!in!Kananaskis!Hall!M!sharing!with!/!partager!avec:!
!!!!!!!!!Le!coût!inclus!une!chambre!de!style!résidence!pour!étudiants,!pour!deux,!dans!la!salle!Kananaskis!
!
!
!!!Single!Occupancy!Option!in!Kananaskis!Hall!(as!above)!is!at!an!additional!cost!and!is!subject!to!limited!availability.!
!!!!!!!!Possibilité!d'occuper!une!chambre!comme!décrite!ciMhaut!pour!une!personne!dans!la!salle!Kananaskis!
!
!!Apartment!Option!in!Yamnuska!Hall!is!an!additional!cost.!Subject!to!limited!availability!!(
!one!bedroom!!!or! !two!
bedroom!apartments)!!!/!Possibilité!d'occuper!un!appartement!dans!la!salle!Yamnuska!pour!un!coût!supplémentaire!et!
avec!disponibilité!pouvant!être!limitée.!!!!!!!!!(Appartements!d'une! !ou!deux!chambres! )!
Meals%I%Repas!
!!!Saturday!dinner!served!from!5:15!pm!to!6:45!pm!!/!!Samedi!!le!souper!sera!servi!entre!17:15h!et!18:45!!
Special!Diet:! !Diabetic!/! !Celiac!/! !Vegetarian!/! !Vegan!/! !Other!(specify):!
!
Diète!spéciale:! !Diabétique/!! !Coeliaque!/! !Végétarien!/! !Végétalien/! !Autre!(veuillez!préciser):!
Notes!on!my!food!requirements!/%Remarques!sur!mes!besoins!alimentaires!
%
!
Other%Activities%I%Autres%Activitées!
Are!you!interested!in!any!of!these!other!activities!connected!to!Senior's!Week?!!We!will!contact!you!with!more!information!
if!any!options!are!checked.!!/!!ÊtesMvous!intéressé!par!d’autres!activités!liées!à!la!Semaine!des!Aînés?!Nous!vous!
recontacterons!avec!plus!d’informations!si!des!options!au!bas!sont!cochées.!
!Calgary!Stampede!Rodeo!&!Grandstand!tickets!/!Billets!pour!le!Rodéo!et!le!spectacle!Grandstand!au!Stempede!de!Calgary!
!Trip!to!Rocky!Mtns!with!stays!in!Banff,!Lake!Louise!/!Des!voyages!dans!les!Montagnes!Rocheuses,!avec!séjours!à!Banff,!Lac!Louise!
!Rocky!Mountain!Railroad!Tour!Calgary!to!Vancouver/!Une!randonnée!dans!le!train!Rocky!Mountaineer,!de!Calgary!à!Vancouver!
!Day!Trip!to!Alberta!Badlands!Royal!Tyrrell!(Dinosaur)!Museum!!/!Un!voyage!de!jour!au!Musée!Royal!Tyrrell!d'Alberta!(dinosaures)!!
Workshop%Information%%%%%%%%%%%I%Coût%et%Coordonnées%
Cost:!$550!A!$50!nonMrefundable!deposit!is!required!at!time!
of!completed!registration.!
Cost!includes!the!required!deposit,!accommodation!(double!
occupancy),! meals,! workshop! and! the! suggested! donation!
($110).!!Please!Register%by%March%31,%2014.!!!!
TMshirts!are!additional!$20!and!must!be!preMordered!when!
you!register.!!
!
The!workshop!starts!on!Saturday!June!28!at!7!pm!and!
finishes!on!Thursday,!July!3!at!noon.!
University!of!Calgary:!2500!University!Dr!NW,!Calgary!
!
Calgary!branch!coordinates:!
2310M24th!Street!SW,!Calgary,!Alberta!T2T!5H8!
[email protected]!!!
Tel:!(403)!240M4566!!!!!!Fax:!(403)!240M4609!
General!Enquiries:[email protected]!
Registrations:[email protected]!
Coût:!550$!On!demande!un!dépôt!nonMremboursable!de!50$!
lors!de!l'inscription.!
Coût! incluant! le! dépôt,! l'hébergement! pour! deux! (chambre!
double),!les!repas!et!le!don!suggéré!(110$).!!
Date%limite%pour%l'inscription%31%mars%2014.%%%
Les!TMshirts!sont!de!20$!supplémentaire!et!doivent!être!préM
commandés!lors!de!l'inscription.!
!
L'atelier!commence!le!samedi,!28!juin!à!19h!et!se!termine!le!
jeudi,!3!juillet!à!midi.!
Lieu:!L’Université!de!Calgary!2500!University!Dr!NW,!Calgary!
!
Section!de!Calgary:!!
2310M24th!Street!SW,!Calgary,!Alberta!T2T!5H8!
[email protected]!!
Tel:!(403)!240M4566!!!Fax:!(403)!240M4609!
Questions!générales:[email protected]!
Registrations:[email protected]!
!
!
Release, Waiver and Indemnity
In consideration of acceptance of my registration as a participant in FLK, access to FLK’s premises or participation in any of FLK’s programs and activities (which
include the Taoist Tai Chi™ arts and Fung Loy Kok Taoist Tai ChiTM arts), I, the applicant, hereby: 1) WAIVE ANY AND ALL CLAIMS that I have, or may in the future
have, against FLK and its directors,officers, members, employees, instructors, agents, representatives, volunteers, successors and assigns (collectively, the
“Releasees”) and RELEASE AND DISCHARGE THE RELEASEES from any and all liability for any loss, damage, or injury that I may suffer, including, but not limited
to, personal injury, death, illness, loss of or damage to my property or property in my possession, resulting directly or indirectly from my presence at or use of FLK’s
premises or my participation in any of FLK’s programs and activities, due to any cause whatsoever, including negligence, breach of contract or breach of any statutory
or other duty of care on the part of the Releasees; and 2) agree to INDEMNIFY AND HOLD HARMLESS THE RELEASEES from any and all claims or demands which
may be made against the Releasees, and any and all loss, liability, damage or costs the Releasees may incur, arising out of or in consequence of my presence at or
use of FLK’s premises or my participation in any of FLK’s programs and activities. I represent and warrant that I am at least of the age of majority in the province in
which I reside. I agree that this Release, Waiver and Indemnity is intended to be as broad and inclusive as is permitted by applicable law and that if any portion is held
invalid, the balance shall, notwithstanding, continue in full legal force and effect. I agree that this Release, Waiver and Indemnity shall be binding on my heirs, next of
kin, executors, administrators, assigns and personal representatives. This agreement shall be governed by and interpreted in accordance with applicable Provincial
laws.
Décharge, renonciation et indemnisation
En contrepartie de l’acceptation de mon inscription en tant que participant au FLK, de l’accès à ses locaux ou de la participation à un de ses programmes et de ses
activités (comprenant les arts Tai Chi TaoïsteMC et les arts Fung Loy Kok Tai Chi TaoïsteMC), je, le demandeur : 1) RENONCE À TOUTE RÉCLAMATION que je peux
avoir, ou pourrais avoir à l’avenir, contre le FLK et ses administrateurs, dirigeants, membres, employés, instructeurs, agents, représentants, bénévoles, successeurs et
ayants droit respectifs (collectivement, les « renonciataires ») et DONNE QUITTANCE AUX RENONCIATAIRES ET LES DÉCHARGE de toute responsabilité pour
toute perte, tout dommage ou toute blessure que je pourrais subir, y compris, mais sans s’y limiter, des blessures, le décès, la maladie, la perte ou les dommages
subis à ma propriété ou à des biens en ma possession, résultant directement ou indirectement de ma présence ou de l’utilisation des locaux du FLK ou de ma
participation à l’un des programmes ou l’une des activités du FLK, pour quelque cause que ce soit, y compris par négligence, rupture de contrat ou violation d’une
obligation légale ou autre devoir de diligence de la part des renonciataires, et 2) accepte d’INDEMNISER ET D’EXONÉRER LES RENONCIATAIRES de toute
réclamation ou demande qui pourrait être portée contre eux, et toute perte, responsabilité, dommages ou frais que les renonciataires pourraient subir, résultant de ou
en conséquence de ma présence ou de l’utilisation des locaux du FLK ou de ma participation à l’un des programmes ou l’une des activités du FLK. Je déclare et
garantis que j’ai atteint au moins l’âge de la majorité dans la province où je réside. Je conviens que cette décharge, renonciation et indemnisation est destinée à être
aussi large et inclusive que la loi le permet et que, si une partie est jugée invalide, le reste, nonobstant, restera en vigueur et aura plein effet juridique. Je conviens que
cette décharge, renonciation et indemnisation liera mes héritiers, proches parents, exécuteurs, administrateurs, ayants droit et représentants personnels. Cet accord
est régi et interprété conformément aux lois fédérales et provinciales applicables.
Date:
Signature: [sign original on arrival in Calgary]
_______________________
For Office Use Only
Date Paid / Notes
Cash $
Workshop " $50 deposit " $500
T-shirt
" $20
Other
"
!
Cheque $
Credit $
Transaction Sheet #
NATIONAL SENIORS WEEK 2014!
REGISTRATION INFORMATION
Greetings to all FLK-TTC Seniors .....and your younger Tai Chi friends!!
!
Registration for National Seniors Week 2014, hosted by Calgary/Western Region, will
commence November 1, 2013. To help with your planning and choices, there is important
information we want you to know about.
DEPOSIT TO ACCOMPANY
REGISTRATION!
A $50 non-refundable deposit will be
required at time of registration. This is being
implemented to defray the costs incurred
when a registration is cancelled after the
commitment deadline with the venue. Please
email your completed registration form to
[email protected] and
mail a cheque or money order (Canadian or
U.S. dollars) to the Calgary office, or mail
both deposit and registration form to the
Calgary office at:!
! Fung Loy Kok Taoist Tai Chi™!
! 2310-24th Street S.W.!
! Calgary, Alberta, Canada T2T 5H8 !
Please register by March 31, 2014 to
ensure we have accommodation for you.!
!
PRE/POST ACTIVITIES!
The Western Region offers easy access to a host
of other activities for our guests to enjoy before
and/or after Seniors Week. We will connect you to
our designated travel agent in Calgary. !
Pre/post accommodation at the University of
Calgary (UofC) is available and you can
make those arrangements directly with the
UofC. (We will connect you with the group
sales manager). Bonus! the night before
(June 27th) and the night after (July 3rd) you
can have your room at the group rate ($52
plus taxes in the dorm style room). Post
workshop, the rate is $82 plus taxes. As it will
be Stampede Week, this is a bargain! !
You may opt to book into a one or two
bedroom apartment for your pre/post activity,
or the whole visit. The group sales manager
will advise of rates for these other options
when contacted.!
OPTIONAL ACCOMMODATION DURING
NSW 2014!
The $550 cost includes the required deposit,
accommodation (double occupancy), meals,
workshop and the suggested donation ($110).
T-shirts are $20 and must be ordered when you
register. Please indicate size on registration form.!
!
If you would like to stay in one of the options,
the extra cost for the five nights is as follows:!
• Single Occupancy Option in Kananaskis
Hall Add $142 to basic $550. Availability is
limited and first-come first-served.!
• Apartment Option in Yamnuska Hall:!
• One bedroom apartment with one
double bed: add $300. Suitable for a
single or a couple. Availability is very
limited and first-come first-served.!
• Two bedroom apartment with one
double bed in each bedroom: add $507
(split between occupants). Single or
double occupancy per bedroom.
Availability is limited and first-come firstserved.!
For more details on accommodation options,
please check our website at http://western.canada.taoist.org/nsw2014!
!
FLIGHT INFORMATION!
Westjet is offering a 10 percent discount valid
for Westjet flights into and out of Calgary and
Edmonton, and available for travel seven
days prior to and seven days after National
Seniors Week. If you are planning to fly
Westjet and would like to take advantage of
this discount please contact Pervin at:!
Tel: 604-266-1712 or Fax: 604-266-6240!
email: [email protected]