Application Form

Registration Information:

Stunt-Course (Phase 1 - 6 Sessions) Total Cost.....................................$4,500.00

50% Deposit, $2,250, is required to confirm a registration. The balance ($2,250) is required ten days before the selected course begins, unless special arrangements have been made with the administration.

Registration will be taken on a "first-come, first-served basis." Any course with less than (4) students may be rescheduled for the next available course. Kahana's Stunt School reserves the right to cancel any session or course due to lack of enrollment, current production, unsafe weather conditions or other circumstances as dictated by the instructor.

Acceptable payment: Cashier's & traveller's checks or cash. No personal checks.

Refund Policy: To request a refund, contact our credit department, Monday thru Thursday between 10:00am and 3:00PM or mail a certified or registered letter. A refund will be issued if he/she notifies our office of cancellation (in writing) two business days before the scheduled course begins. A $1,250.00 handling fee will be deducted for each refunded class. After the refunded deadline has passed, no refund will be made. Refunds can immediately be received in the form of a "Credit Coupon" that may be used for a future class. Coupons are valid for one year from date of issue. A refund check shall be issued within 4 to 6 weeks after the start of a session.

Due to the exceptional demand for classes: No exceptions to this refund policy are made. Please send boarding information: Yes_______ No ________

Name: ___________________________ Birthdate: ____________ Age: ________ Ht: ______ Wt: ______ (Male/Female)

Address: _____________________________ City: ___________________ State: __________ Zip: ________

Home Phone: (___) _____________ Work Phone: (___)_____________ E-mail Address: _________________

Social Security #: _____________ Union Member (SAG/Aftra) Yes ___ No ______ If Yes, Card # __________

Please include doctor's approval.

Please send snapshot with application.

I recognize that the various techniques in which I will be trained are highly dangerous and I assume all risks for any injury which may occur to me or others, through anything other than but still including, intentional and malicious injuries acts. I also agree to sign a complete waiver of liability on the part of Kahana's Stunt School and SAC, Inc. before engaging in any activities. I understand that I am responsible for my own insurance.

I HAVE READ AND UNDERSTAND THIS APPLICATION FORM

Signed: ___________________________________________ Date:___________________

Please PRINT NOW!

Please send or fax this page to Kahana's Stunt School
P. O. Box 127
Groveland, FL 34736
Office (352) 429-4561 | Fax (352) 429-4029

| Sessions & Descriptions | Kahana Stunt School Page | Dormitory Application |

E-mailKahanastunts

P. O. Box 127
Groveland, FL 34736
Office (352) 429-4561 | Fax (352) 429-4029

Make payable to:	Kahana's Stunt School.

Check in the amount of (check one):

	$2,250.00
	$4,500.00

Stunt Courses (check next to your preferred date):
	March 24, 2008 thru April 25, 2008
	September 29, 2008 thru October 31, 2008