Asli Kala jadu, Black magic specialist in Pakistan Or Kala jadu expert in Egy...
Iii. wieselburg 2011 inglisch
1. Organization: IJJOR Jujutsu Onkochishin Ryu - RKAF Ryukyu Kobudo Austria Federation
www.jujutsu-onkochishinryu.com www.kobudo-rkaf.com
Place: Francisco Josephinum - Schloss Weinzierl 1 A-3250 Wieselburg
Tel. +43 7416 52437 0 Fax. +43 7416 52437 49 Austria
Arrival: Sunday, July 17, 2011 Check-in from 15:00
Departure: Saturday, July 23, 2011 – Check out until 09:00 a.m
Total cost (including full board residential and training)
Adults (Age 18+) Euro 340,--
Adolescents (Age 14 - 17) Euro 325,--
Children (Age 6 - 13) Euro 300,--
Escort Euro 280.-
Applications are possible until June 15, 2011. When the bank transfer can be confirmed the registration
will be completed.
Entry form and confirmation of payment are to be sent to: Franz Gschlad seminar.ijjor.rkaf@gmail.com
Subject for transfer: IV. Sommercamp -Wieselburg 2011 Austria
data:
Bank data Bank Raiffeisenkasse Michelhausen
Bank Account Nr: 879 395
BLC: 32497
IBAN: AT 343249700000879395
BIC/SWIFT Code: RLNWATW1497
Course trainers: Belgium Johny Lenskens - Hakko Ryu Jujutsu Hanshi
Italy Roberto De Ronzi - Jiu Jitsu Shihan
Italy Jino Nosi Karate - Shito Ryu Shihan
Germany Wolfgang Siebel ( Honorary Master ) Karate Shoto KanShihan
Spain Vicente Borondo - Jodo y Kenjutsu Shomokuroku
Spain Marcos Sala Ivars - Seitei Iaido Sensei
Switzerland Ralph Irminge - Penka Siltat Haka Tahir Sensei
Austria Maria Schmöllerl - Goshindo
Spain David Rodriguez – Kobudo Okinawa
Austria/Spain Jesus Potrero - Jujutsu/ Kobudo Shihan
Couser instructors:
President: Jesus Potrero
Coordination: Haas Harald und Franz Gschlad
Medical attendance: Dr. Claudia Prenner
Child care: Maria Ellinger
Brigitte Horner: Gimnastics
2. Organization: TDKM – ROBERTO DE RONZI
www.jujutsu-onkochishinryu.com www.kobudo-rkaf.com
Place: Francisco Josephinum - Schloss Weinzierl 1 A-3250 Wieselburg
Tel. +43 7416 52437 0 Fax. +43 7416 52437 49 Austria
Arrival: Sunday, July 17, 2011 Check-in from 15:00
Departure: Saturday, July 23, 2011 – Check out until 09:00 a.m
Total cost (including full board residential and training)
Course TDKM Euro 400,--
Full board Euro 300,--
Course + Full board Euro 675,--
Escort Euro 300.-
Applications are possible until June 15, 2011. When the bank transfer can be confirmed the registration
will be completed.
Entry form and confirmation of payment are to be sent to: Franz Gschlad
seminar.ijjor.rkaf@gmail.com
Subject for transfer: I. COURSE TDKM -Wieselburg 2011 Austria
data:
Bank data Bank Raiffeisenkasse Michelhausen
Bank Account Nr: 879 395
BLC: 32497
IBAN: AT 343249700000879395
BIC/SWIFT Code: RLNWATW1497
Course trainers: Itali Roberto De Ronzi
3. Acceptance of parents or guardians
Consent Form
Name of parents or guardians: _______________________________________________
Name of participating minor: ________________________________________________
____________________________________________________________________________________
I agree that my son/my daughter will participate in IV. International Sommercamp 2011
Wieselburg – Austria
which is organized by Ryukyu Kobudo Austria Federation and Ju-Jutsu Onkochishin Ryu from
17th July – 23th July 2011 at
Francisco Josephinum - Schloss Weinzierl 1 A-3250 Wieselburg
Tel. +43 7416 52437 0 Fax. +43 7416 52437 49 Austria
All pictures and videos which are made of my son/my daughter during the course can be used for non-
commercial purposes.
I confirm that my son/my daughter has no illness or allergies which exclude him/her from a normal
participation in the course.
.
______________________________________ ________________________________________
Date, Place Signature of parents or guardians
4. Confidential data of the participant
Data will be treated confidentially. The information is for the kitchen crew in case of special diets, for medical
purpose in case of emergencies and for the course instructors.
Vaccinations: __________________________________________________________________________
______________________________________________________________________________________
Allergies against medicaments, insect bites, food or others? YES G NO G
Please list the allergies with symptoms and required medical treatment (medicaments):
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Do you need any special medication or are you in medical treatment? YES G NO G
If YES, which one? ________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
In which interval and dose do you need the medicaments? _________________________________________
________________________________________________________________________________________
Which reactions could appear? _______________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Do you want vegetarian food? YES G NO G
Do you need a special diet? YES G NO G
If YES, which one? ________________________________________________________________________
Which reactions could occur? _______________________________________________________________
____________________________ ___________________________________________________________
Date, Place Signature of participant or parents or guardians
5. Contact in case of emergency
Parents or guardians:
Name:____________________________________________________
Address:__________________________________________________________________________
_____________________________________________________________________________________
Phone nr. (Home) ______________ Phone nr. (Work) _______________ Mobile phone nr. _________
Doctor or hospital which should be contacted:
Name:____________________________________________________________
Address:_____________________________________________________________________________
Phone Nr. 1.________________________________Phone Nr. 2.____________________________________
Others:
1. Name.__________________________________ Phone Nr._____________________________________
2. Name.__________________________________ Phone Nr._____________________________________
3. Name.__________________________________ Phone Nr._____________________________________
Date, Place Signature of parents or guardians
6. Entry form
Course: G IV. Internationale Summer Camp Wieselburg 2011 - G TDKM Assitant Instructor Class -A-
Name:
Street:
Postal code: Place:____________________ Country:
Phone Nr.: Date of birth:
E-Mail.:
Association or club:
I practise:
GJu-Jitsu GKarate GKobudo GJudo GAikido GKrav Maga GPenka Siltat GJodo
GIaido GOthers; _________________________________________________
Weapons, as far as available, please take
Which are required waffen; GJo stick 1,27cm GBokken GTanto GIaito or Katana.
Kobudo weapons: G Bo G Nunchaku G Tunfa G Sai
G Yes, I want to go to Wieselburg and back to Vienna by bus. Extra costs Euro per person
G There and Return: Euro 40,--
G To route: Euro 25,--
G No, I don’t need the bus transfer
________________________ _________________________
Signature of participant Signature of parents or guardians
Deadline: 15th June 2011
Attention: Limited number of participants
Entry form and confirmation of payment are to be sent to: Franz Gschlad seminar.ijjor.rkaf@gmail.com
Subject for transfer: IV. Sommercamp -Wieselburg 2011 Austria
data:
Bank data Bank Raiffeisenkasse Michelhausen
Bank Account Nr: 879 395
BLC: 32497
IBAN: AT 343249700000879395
BIC/SWIFT Code: RLNWATW1497
Reason for transfer: IV. Sommercamp -Wieselburg 2011 Austria
I. TDKM Assistent Instructor Classe A
7. Map of wieselburg
.
Highway A1 – Exit E60 , B25 towards “Wieselburg”.
After the main square „Hauptplatz Wieselburg“ take
the Grestner Straße towards Weinzierl.
In Weinzierl go towards Wechlinger Straße.
The parking place is near the main entrance of
Francisco Josephinum.
Inside there will be direction signs.