Community Enrichment • Winter 2019 • 冬学期
CLASS SCHEDULE MLB MARINERS OPENING GAME AND SUMO IN JAPAN! page b
RETIREMENT PLANNING AND WEALTH PRESERVATION page f
INDOOR AIR QUALITY AND YOUR HEALTH page e
THE GUT MICROBIOME AND PROBIOTICS page e
JOIN ANNUAL MEMBERSHIP & SAVE A $35 Nikkei Horizons full year membership (January through December 2019) entitles you to access FREE community-sponsored classes / workshops and most importantly discounts on most activities. JOIN TODAY!
HOW DO I REGISTER? Complete registration form and mail or bring to Nikkei Horizons with payment (check, credit card, or cash), register over the phone at (206) 726-6501, or register online at: www.keironorthwest.org.
ADVENTURES MLB MARINERS OPENING GAME AND SUMO IN JAPAN! (Only a few spots left)
ORIENTATIONS SCHEDULED FOR UPCOMING 2019 TOURS AT KEIRO NORTHWEST
Time: TBA • Sea-Tac International Airport Price / land only / 7 days 6 nights: $3,350 pp/double occupancy • $4,000 pp/single Group Airfare: Please contact Rie Taki at 206-726-6469
ULTIMATE JAPANESE SUMMER FESTIVALS
Please register in advance! Wonder Of China And The Yangtze River Saturday, February 16 | 10:00 a.m. – 12:00 p.m.
Shout “Go Mariners!” in Japan! MLB official opening game Seattle Mariners vs. Oakland Athletics will take place at Tokyo Dome Stadium in Japan! You will also enjoy Sumo Tournament in Osaka, experience sumo workshop, Mt. Fuji, Amanohashidate, one of the three best scenic views in Japan, and unique experiences sightseeing in Osaka, Kyoto and Tokyo. Limited spaces! Tuesday, March 12 – Thursday, March 21 Time: TBA Sea-Tac International Airport Price / land only / 10 days 8 nights: $5,550 pp/double occupancy • $6,500 pp/single Tour deposit: $800 upon registration Air Reservation: Please contact Rie Taki at 206-726-6469
HISTORIC TRAILS AND THE GREAT SMOKY MOUNTAINS
European Christmas Market Tour Saturday, February 23 | 1:00 p.m. – 3:00 p.m. If you are interested in any of the tours listed below, please contact Rie Taki at (206) 726-6469 | NHinfo@keironw.org
Time: TBA • Sea-Tac International Airport Price / land only / 9 days 8 nights: $3,699 pp/double occupancy • $4,599 pp/single Group Airfare: Please contact Rie Taki at 206-726-6469
HEART MOUNTAIN, TOPAZ, YELLOWSTONE & MOUNT RUSHMORE
(Waiting list only)
Wednesday, September 25 – Tuesday, October 8 Time: TBA • Sea-Tac International Airport Price / land only / 13 days 11 nights: $4,899 pp/double occupancy • $7,549 pp/single Group Airfare: Please contact Rie Taki at 206-726-6469
EUROPEAN DISCOVERY TOUR – FOLLOWING IN THE FOOTSTEPS OF THE 442ND
Kingdoms Of Southeast Asia – Vietnam, Cambodia And Laos Saturday, February 16 | 1:00 p.m. – 3:00 p.m. Ultimate Japanese Summer Festivals Tour Saturday, February 23 | 10:00 a.m. – 12:00 p.m.
with private balconies on Holland America. Includes local tours in: Dubrovnik, Croatia; Kotor, Montenegro; Corfu, Greece; Katakolon, (Olympia) Greece; Santorini, Greece; Athens, Greece and Pompeii, Italy.
Interested? Please sign up for the tour orientation - Saturday, February 23 | 10:00 a.m. – 12:00 p.m. @ Keiro Northwest You will be blown away by three spectacular Japanese summer festivals! Nikkei Horizons is offering you an exclusive tour to enjoy the best and world-renown festivals - Niigata Nagaoka Fireworks Festival, Akita Kanto Festival and Aomori Nebuta Festival on August 1 - 9 (9 days 7 nights). This tour includes a stop in Morioka, Iwate and 2 nights in Tokyo including some free time. Thursday, August 1 – Friday, August 9 Time: TBA • Sea-Tac International Airport Price / land only / 9 days 7 nights: TBA at tour orientation (Please register in advance!) Group Airfare: Please contact Rie Taki at 206-726-6469
ITALY, CROATIA AND GREECE CRUISE
(Waiting list only)
Join us on a private, fully escorted Nikkei Horizons tour as you travel to the heart of Europe in Fall 2019 to experience some of the most spectacular cities and scenery in the world. Along the way, you will visit several of the sites where brave Nisei soldiers fought in World War II. The major destinations in Italy and France will be Rome, Monte Cassino, Pisa, Florence, Tuscany, Bruyères, Epernay, Champagne, and Paris. This tour will be led by Philippe Thériault, experienced tour director and guide. The towns of Bruyères and Biffontaine are holding the Commemoration of the 75th Anniversary event and the Keiro Northwest group has been officially invited! Experience this wonderful and informative journey. Saturday, October 12 – Wednesday, October 23 Time: TBA • Sea-Tac International Airport Price / land only / 12 days 10 nights: $5,459 pp/double occupancy • $6,599 pp/single Group Airfare: Please contact Rie Taki at 206-726-6469
Discover the heart of the Appalachian Mountains and visit some of America’s most iconic sites along the way! Including: Gettysburg PA, Shenandoah NP, Lexington KY, Mammoth Caves NP, Nashville TN, the Country Music Hall of Fame, Pennsylvania’s Amish Country, the largest Toyota Factory in North America and fabulous Biltmore Estate. Monday, May 13 – Tuesday, May 21 b
Join us on a journey of the heart: visit Heart Mountain. Highlights include: Salt Lake City, Topaz, Grand Tetons, Yellowstone, Heart Mountain, Battle of Little Big Horn, Devil’s Tower, Mount Rushmore and Crazy Horse Memorial. Monday, June 10 – Sunday, June 16
(206) 726-6469 / 6501 • 1601 E. Yesler Way, Seattle, WA 98122 • www.keironorthwest.org
Join us on a fabulous Mediterranean cruise (10 days) hosted by Philippe Thériault! Cruising is easy and we’ve made it even better. This tour includes a one-day, pre-cruise stay in Rome to help you rest before you sail and all of your local sightseeing. Philippe has carefully selected the best cruise ship and excellent cabins
ICON KEY
Japanese OK
Evening
Nikkei Horizons • A Community Enrichment Program of Keiro Northwest
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WONDER OF CHINA AND THE YANGTZE RIVER
Friday, November 22 – Thursday, December 5 Time: TBA • Sea-Tac International Airport Price / land only / 14 days 12 nights: TBA at Tour orientation (Please register in advance!) Group Airfare: Included in the tour package
EUROPEAN CHRISTMAS MARKETS!
Friday, November 8 – Saturday, November 23 Time: TBA • Sea-Tac International Airport Price / land only / 16 days 14 nights: TBA at tour orientation (Please register in advance!) Group Airfare: Included in the tour package
KINGDOMS OF SOUTHEAST ASIA – VIETNAM, CAMBODIA AND LAOS
Interested? Please sign up for the tour orientation - Saturday, February 16 | 1:00 p.m. – 3:00 p.m. @ Keiro Northwest Begin in Vietnam and explore its complex relationship with the West. Learn unique culinary secrets in the ancient town of Hoi An. Cruise overnight aboard a luxury junk boat on Ha Long Bay. Find inspiration at Cambodia’s Angkor Wat temple, experience interactions with local villagers and a journey on the Mekong River. Hear the history of the notorious Khmer Rouge. From contemplating the Fall of Saigon to exploring a once forgotten temple deep in the jungle and more. d
Make new friends and try different restaurants around the Puget Sound area. The first stop on this series is Junkichi Robata Izakaya, an authentic Japanese cuisine utilizing a live fire charcoal grill. Please indicate on your registration form which dates you will attend. Participants pay for their own meals at the restaurant. Wednesday, January 23, February 20 and March 27 11:00 am – 2:00 pm (or TBD) Seattle Buddhist Church Parking Lot • 22 Person Limit Annual Member $25 per single outing • $70 for three outings Non Annual Member $30 per single outing • $85 for three outings (Includes transportation and expenses for driver and escort)
Interested? Please sign up for the tour orientation - Saturday, February 16 | 10:00 a.m. – 12:00 p.m. @ Keiro Northwest The allure of the Eastern world unfolds before you on a spellbinding journey through the ancient and modern marvels of China. Highlights include: Beijing, Xian, and boat cruising along the Yangtze River. Disembark at Chengdu and end in Shanghai.
LUNCH BUNCH
Interested? Please sign up for the tour orientation - Saturday, February 23 | 1:00 p.m. – 3:00 p.m. @ Keiro Northwest Enjoy live classical music, visit fairytale castles, savor hearty winter cuisine and experience local culture during a magical time of the year in some of Europe’s prettiest towns and villages. This will definitely be an unforgettable tour! Monday, December 9 – Wednesday, December 18 Time: TBA • Sea-Tac International Airport Price / land only / 10 days 8 nights: TBA at Tour orientation (Please register in advance!) Group Airfare: Please contact Rie Taki at 206-726-6469 Special payment schedule and cancellation policy apply for all tours. Group Travel Insurance information is available for overnight tours. Please call Nikkei Horizons office (206) 726-6469 or visit www.keironorthwest.org for details. Keiro Northwest/Nikkei Horizons is registered with the State of Washington as a seller of travel. Registration number; 600-211-035. Itineraries subject to change. Most adventure tours include walking and stairs. If you have any concerns, please consult Nikkei Horizons before registering.
(206) 726-6469 / 6501 • 1601 E. Yesler Way, Seattle, WA 98122 • www.keironorthwest.org
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TEATRO ZINZANNI IN WOODINVILLE
Let’s spend magical hours with your friends and family at Teatro ZinZanni newly opened in Woodinville! It is a three-hour whirlwind of international cirque comedy, and cabaret artists all served up with a scrumptious multi-course feast and elegant libations. Please join the matinee show to experience the indescribable unique world in the Spiegel tent with the menu by James Beard Award-Winning Chef, Jason Wilson!
SPECIAL OFFERINGS! Join our new and one-time offerings geared to improve your health, plan ahead for life transitions, maintain your independence, and improve your quality of life.
LIVING WELL SERIES! INDOOR AIR QUALITY AND YOUR HEALTH Casey Coulombe of the American Lung Association will discuss a holistic approach to indoor air quality including: dust, mold, smoke, chemicals, and green cleaning. Join us to learn how to improve your indoor air quality! Casey Coulombe American Lung Association in Washington Thursday, February 21 • 10:30am – 12:00pm Keiro Northwest • 14 person limit $10 Member • $20 Non-Member
PREPARING FOR A DOCTOR’S VISIT We all need to visit a doctor from time to time, some more than others. Being an advocate for yourself or a loved one is one way you can make the best use of you and your doctor’s time. Take charge of your healthcare and partner with your doctor and healthcare team. Mary Whittington, RN, MSM Stroke Quality Improvement Nurse Consultant WA Coverdell Acute Stroke Program Wednesday, March 5 • 10:00 am – 11:30 am Keiro Northwest • 14 person limit $10 Member • $20 Non-Member
THE GUT MICROBIOME AND PROBIOTICS (New location)
© MICHAEL CRAFT
Sunday, April 14 10:00 am – 3:30 pm Seattle Buddhist Church Parking Lot • 14 Person Limit Annual Member $140 • Non-Member $150 (Includes transportation, 3 hour show, four course menu, one non-alcohol beverage, tax, gratuity, handing fee and expenses for driver and escort) Registration deadline and tour cost non-refundable date: February 28, 2019
Life expectancy continues to increase globally and is expected to reach the mid-70s by 2050. Maintaining health in older age depends on the appropriate function of our homeostatic systems (nervous, endocrine and immune). Maintaining optimal health also involves correct interactions between these systems and our gut microbiome. Probiotics play a major role in helping to maintain this balance. Come learn about what you can do to support your own microbiome!
Nikkei Horizons • A Community Enrichment Program of Keiro Northwest
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Maureen Grant, RN Iora Primary Care Thursday, March 14 • 10:00 am – 11:30 am Iora Primary Care • 306 23rd Ave South Suite 200, Seattle, WA 98144 20 Person Limit FREE Annual Member • $10 Non-Member
FENG SHUI AND DECLUTTERING Do you have too much stuff? Does it overwhelm you? You are not alone! Most people tend to accumulate things over the years. We buy a little souvenir here and there. We receive gifts too. And yes, we all have photos that hold wonderful memories. They are all so special. It’s no wonder we all have so much “stuff”. Feng shui is not only about our physical space, we also learn about the energy of the space. In this class we will discuss why and how we can declutter. With a better understanding of the psychology behind why we struggle to let go, it will help you start to take action. We will also discuss easy organization tips and methods for decluttering. Jenny Hones www.ThreeFrogsDesign.com Tuesday, March 12 • 10:30 am – 12:00 pm Keiro Northwest • 14 Person Limit Annual Member $10 • Non-Annual Member $20
LIVING INDEPENDENTLY RETIREMENT PLANNING AND WEALTH PRESERVATION
Jon Alejandro Heartland Institute of Financial Education Thursday, February 7 • 10:30 am – 12:00 pm Keiro Northwest • 14 person Limit Annual Member $10 • Non-Annual Member $20
AARP SMART DRIVER COURSE 2018 Attend this two day classroom workshop and become a better, safer driver and reduce your risk of a crash. Learn about new vehicle safety features. Explore the many options available to manage life without a car. Course participants over the age of 55 will receive a multi-year discount on their auto insurance premiums. Two driver households may need both drivers to attend to get the maximum discount. Pre Course Assignment: Review your auto insurance policy. For extra credit bring newspaper articles about car crashes to class and/or take the DOL practice test: http://www.dol.wa.gov/driverslicense/practicetest. html Participant Cost: Bring your checkbook. A check payable to AARP is required for the workshop materials. $15 for AARP members, $20 for non-members. Bring your AARP card to get the member discount. A 30-minute lunch break is included. Please bring your own lunch. You must attend the two days to complete the workshop. Fred Sakura Monday and Wednesday, February 25 and 27 • 10:00 am – 3:00 pm • Keiro Northwest • 14 Person Limit FREE for all **Fee for materials to AARP applies. Please see the description above.
“Hope” isn’t a plan. This workshop is designed to inform and educate participants on the basic concepts of properly planning for retirement and how you can preserve your assets for generations to come. Learn about the different income sources for retirement savings, ways to maximize your savings, how to better prepare for health care costs, and the importance of proper estate planning. Note: below are the topics covered: • What sources of income will you have for retirement • Understanding the key differences among IRAs and retirement plans • Understand different types of Annuities • Understand what Medicare covers • Importance of Estate Planning f
(206) 726-6469 / 6501 • 1601 E. Yesler Way, Seattle, WA 98122 • www.keironorthwest.org
WEEKLY CLASSES ARTS & CRAFTS KNITTING & CROCHETING WITH MARCIA Need motivation to finish those old projects? Join this cozy knitting circle to learn and work with other like-minded knitters! Skilled knitter Marcia Almassy will guide and inspire you on the project of your choice. Supplies needed: knitting needles size 6, 8, or 10, and acrylic or worsted wool knitting yarn. Marcia Almassy Tuesdays, January 8– March 12 (10 weeks) 1:00 pm – 3:00 pm Nikkei Manor • 10 Person Limit Annual Member $50 • Non-Annual Member $60
WOODCARVING — KIBORI Learn the unique woodcarving art form kibori. Naomi Schneider will teach you how to make accessories including watches, mirrors, ornaments, and more! Bring images you would like to carve. Wood blocks and carving tools will be provided for the first class. Students may bring their own tools. A resource list to purchase materials will be available from the instructor. Naomi Schneider Wednesdays, January 9 – March 13 (10 weeks) 10:00 am – 12:30 pm Midori Condos • 10 Person Limit Annual Member $50 • Non-Annual Member $60
EXERCISE & WELLNESS BEGINNERS TUESDAY TAI CHI In this class for beginners, you will become acquainted with Tai-Chi philosophy through this slow, graceful exercise that calms the emotions, clears the mind and rejuvenates the body. Edward Wan Tuesdays, January 8 – March 12 (10 weeks) 12:00 pm – 1:00 pm Seattle Buddhist Church Gym • 30 Person Limit Annual Member $60 • Non-Annual Member $70
ADVANCED TUESDAY TAI CHI This class by Edward Moore is for students continuing or experienced students with Yang Family style Tai Chi.
Edward Wan Tuesdays, January 8 – March 12 (10 weeks) 1:10 pm – 2:10 pm Seattle Buddhist Church Gym • 30 Person Limit Annual Member $60 • Non-Annual Member $70
ENHANCEFITNESS IN SEATTLE A full hour of fun with lively music! EnhanceFitness focuses on dynamic cardiovascular exercise, strength training, balance, and flexibility—everything that active older adults (55 & up) need to maintain health and function as they age. This class is highly adaptable for all fitness levels and includes the option to use a chair for support. Weights are provided. A certified EnhanceFitness instructor will guide your progress. We recommend taking the class at least twice a week. New students will be asked to complete some forms after enrollment. Note: If you are a Kaiser Permanente member with the Clear Care Medicare Advantage plan and wish to take free EnhanceFitness classes, please check with Kaiser Permanente Customer Service about eligibility. Yu-San Gartz Mondays, Wednesdays, and Fridays, January 7 – March 20 (10 weeks / 30 classes – no class January 21, February 18) Seattle Buddhist Church Gym • 35 Person Limit Annual Member $90 • Non-Annual Member $100
PICKLEBALL CLASS Pickleball is a smaller version of tennis, but just as fun. At the end of the class, you will be free to join the other players on Tuesdays and Thursdays. Free to attend with your 2019 Annual membership until December 31, 2019. Always consult your doctor before participating in any physical activity. Shox Tokita and Gordon Sata Class: Thursdays • 9:30 am – 10:30 am Open Play: Every Tuesday & Thursday• 9:30 am – 11:30 am Seattle Buddhist Church Gym • No Limit FREE with Annual Membership (required)
FINANCE NIKKEI HORIZONS INVESTMENT CLUB Join other investing beginners to research, buy, hold and sell investments. Participation in club is expected. National Association of Investors Corporation (NAIC)
Nikkei Horizons • A Community Enrichment Program of Keiro Northwest
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dues ($30) collected annually; club investment contributions ($75) are collected quarterly (Jan, Apr, Jul & Oct). Finance expert Chiaki Hirate will be your advisor. Please renew or join for Nikkei Horizons 2019 Annual Membership (valid through December 31, 2019) when you register. Chiaki Hirate 1st Wednesday of the month – January 9, February 6, March 6 10:00 am – 12:00 pm Seattle Buddhist Church 2F • 20 Person Limit FREE with Annual Membership (required)
FUN & GAMES BRIDGE CLUB Logic, deduction, math, and teamwork are all at work in bridge. Pat Kono keeps your mind and bridge skills sharp. Some bridge experience and knowledge needed.
HANAFUDA CARD GAME Hanafuda (flower cards) are beautifully designed in twelve suits, representing the months of the year and are used to play a number of games. Carla Furukawa keeps tradition alive while having fun learning the game. Carla Furukawa Mondays, January 14 – March 18 (8 weeks, No class 1/21 & 2/18) 1:00 pm – 2:30 pm Midori Condos • 20 Person Limit Annual Member $40 • Non-Annual Member $50
CANCELLATION POLICY
CLASS LOCATIONS
CANCELLATION
Iora Primary Care (New Location) 306 23rd Avenue S., Seattle, WA 98144 (206) 518-9033
Nikkei Horizons reserves the right to cancel a class, workshop, or tour if it does not meet minimum participation requirements, if there is a cancellation of venue, or withdrawal of an instructor. A full refund or credit will be applied. WITHDRAWALS Tuition credit will be granted for weekly classes if you withdraw before the start of 2nd class. Credits are valid until they are used to take other classes. Annual memberships are not refundable. For workshops and local tours, you must withdraw 10 days before the date of the workshop/local tour, in order to receive full tuition credit.
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Pat Kono Thursdays, January 10 – March 14 (10 weeks) 9:30 am – 11:30 am Nikkei Manor • 12 Person Limit Annual Member $50• Non-Annual Member $60
Seattle Buddhist Church Parking Lot (SBC/PL) Corner of 16th Avenue South & South Main Street Seattle Buddhist Church (SBC) 1427 South Main Street, Seattle, WA 98144 (206) 329-0800 Keiro Northwest 1601 East Yesler Way, Seattle, WA 98122 (206) 323-7100 Midori Condos Entrance on 16th Ave South side 1515 East Yesler Way, Seattle, WA 98122 Nikkei Manor (NM) 700 6th Avenue South, Seattle, WA 98104 (206) 726-6460
(206) 726-6469 / 6501 • 1601 E. Yesler Way, Seattle, WA 98122 • www.keironorthwest.org
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HYAKUNIN ISSHU CARD GAME CLUB
毎月第二土曜日の午後、おしゃべりを楽しみながら、百 人一首カルタ会に参加してみませんか？日系ホライゾン百 人一首クラスの元講師、小林福子先生がお世話役をして 下さいます。和歌を暗記されていない方、初心者の方で も興味をお持ちでしたら大歓迎です。 世話役：小林福子 毎月第二土曜日1月12日、2月9日、3月9日 1:30 pm - 3:00 pm みどりコンドミニアム1階会議室 • 20 Person Limit 日系ホライゾン年会員: FREE (年会員登録必須)
CHESS CLUB Let’s play chess and keep your brain fit. This two-player strategy board game is one of the world’s most popular. Yoko Sato coordinates the club in a friendly environment. Let’s have fun together. Free to attend with your 2019 Annual membership until December 31, 2019. Yoko Sato 1st Thursday of the month – January 3, February 7, March 7 1:30 pm – 3:30 pm Midori Condos • 20 Person Limit FREE with Annual Membership (required)
MAHJONG CLUB Let’s play Chinese Mahjong! This class will be open to everyone with Nikkei Horizons Annual Membership. There will be no instructor for this activity. This class is made possible thanks to a special partnership with Kin On Healthy Living Program. Free to attend with your 2019 Annual membership until December 31, 2019. 1st and 3rd Wednesdays 1:00 pm – 3:00 pm Kin On Community Center (address: 4416 S. Brandon St. Seattle WA 98118) • 20 Person Limit FREE with Annual Membership (required)
CULTURE HULA Hula is a wonderful low-impact exercise that tells a story through graceful, expressive movements with beautiful Hawaiian music. You will learn basic steps and some Hawaiian language while enjoying the es-
sence of Hawaiiana. This class fits all levels. Beginners are welcome. Joey Hendrickson Wednesdays, January 9 – March 13 (10 weeks) 12:30 pm – 1:30 pm Seattle Buddhist Church Gym • 25 Person Limit Annual Member $60 • Non-Annual Member $70
NIKKEI HORIZONS UKULELE BANDS Let’s kanikapila! Nikkei Horizons has four ukulele bands- Kimochi, Niko Niko, Na Aikane and Hana Ho, focusing on improving playing skills in a warm, fun, and nurturing atmosphere. Bands meet twice a month and are led by John Iwai, A.C. Arai, Dick Nagaoka, Minako Brunelle and Bill Evenson. Annual Membership is required to join band activities. If you are interested in joining as a new student, please contact Nikkei Horizons office to check times/meeting locations and space availability at (206) 726-6501.
SUMI-E BRUSH PAINTING Learn to paint on rice paper with Asian ink and watercolor. Students paint traditional sumi motifs such as bamboo, flowers, mountains, and trees. Beginner and intermediate painters welcome! Supplies needed: brushes, ink stick, ink stone, sumi paper, water cup, paper towels Midori Kono Thiel Mondays, January 14 – March 18 (8 weeks – no class January 21 & February 18) 1:00 pm – 3:00 pm Seattle Buddhist Church Dining Room • 10 Person Limit Annual Member $40 • Non-Annual Member $50
MIZUHIKI ZAIKU — ADVANCED LEVEL Mizuhiki zaiku is the Japanese art of tying and knotting special colorful cords to create works of art. You will learn to form beautiful and delicate art pieces. Prerequisite: Continuing students only. Supplies needed: small wire cutters, scissors, needle-nosed pliers, and mizuhiki cords. Kathy Carmichael and Rebecca Durham Thursdays, January 10 –February 28 (8 weeks) 9:30 am – 11:30 am Midori Condos • 15 Person Limit Annual Member $40 • Non-Annual Member $50
Nikkei Horizons • A Community Enrichment Program of Keiro Northwest
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WINTER QUARTER 2019 REGISTRATION • 登録用紙
ANNUAL CLUB REGISTRATION FOR 2019 • 登録用紙
This registration form is ONLY for those that would like to participate for the Nikkei Horizons Clubs listed below. Please PRINT, one registration form PER PERSON. This form may be duplicated.
This registration form is for workshops, classes, and tours. Club registration is on a separate form. Please PRINT, one registration form PER PERSON. This form may be duplicated. Name:
Birth Date: M
Address: Primary #: (
City: )
Other #: (
)
/D
M:
New Student: Returning Student:
Zip:
Cell #: (
F:
/Y
E-mail:
)
Native American/Alaska Native
Chinese Japanese
Other Asian Mixed race (check all that apply)
Korean
Other race/ethnicity
Vietnamese
Class/Tour Title
/Y
Location
Please make checks payable to: KEIRO NORTHWEST Mail a check with completed registration form to:
$35 Membership fee valid through December 31, 2019
NIKKEI HORIZONS 1601 E. YESLER WAY, SEATTLE, WA 98122
Donations are appreciated to help maintain our program.
I recognize the risks of injury and illness involved in any physical activity including exercise, in the use of power equipment (e.g. electric or gas), sharp tools, chemicals or any other potentially hazardous material or equipment. I understand that responsibility is not assumed by the leaders, volunteers, sponsoring organization or facility. I specifically agree to hold harmless said leaders, volunteers, sponsoring organization, or facility housing this program from any damages I suffer for any injury or illness attributable to my participation. In addition, I hereby consent to the use of my name, my photograph and or image by Keiro Northwest for the purpose of marketing and fundraising for Keiro Northwest and Nikkei Horizons.
Signature: Emergency Contact Name:
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Cell #: (
Session/Time
Fees/Tuition
(Membership fee $35) Donation to Nikkei Horizons Total Amount
Mixed race (check all that apply)
Korean
Other race/ethnicity
Vietnamese
Language spoken at home:
Card #:
Billing Address if different: Expiration Date: M
Ukulele Band
NH Investment Club
Kimochi Band
Hyakunin Isshu Card Game
Niko Niko Band
Chess Club
Na Aikane Band
Mahjong Club
Hana Hou
OTHER Please make checks payable to: KEIRO NORTHWEST Mail a check with completed registration form to: NIKKEI HORIZONS 1601 E. YESLER WAY, SEATTLE, WA 98122
$35 Membership fee valid through December 31, 2019 Donations are appreciated to help maintain our program.
I recognize the risks of injury and illness involved in any physical activity including exercise, in the use of power equipment (e.g. electric or gas), sharp tools, chemicals or any other potentially hazardous material or equipment. I understand that responsibility is not assumed by the leaders, volunteers, sponsoring organization or facility. I specifically agree to hold harmless said leaders, volunteers, sponsoring organization, or facility housing this program from any damages I suffer for any injury or illness attributable to my participation.
Relationship:
Emergency Contact #:
(206) 726-6469 / 6501 • 1601 E. Yesler Way, Seattle, WA 98122 • www.keironorthwest.org
(Membership fee $35) Donation to Nikkei Horizons Total Amount
KEIRO NORTHWEST WAIVER & CANCELLATION POLICY
WITHDRAWALS: Tuition credit will be granted for weekly classes, if you withdraw before the start of 2nd class. Credits are valid until they are used to take other classes. Annual memberships are not refundable.
911 will be called in the event of an accident or medical emergency.
Please do not add me to the email list.
CVC:
Pickleball
To the extent necessary, because of my health history and general physical condition, I have consulted my personal physician for advice and approval before participation and agree to obtain my own health or accident insurance to cover accidental injury or illness.
For workshops and local tours, you must withdraw 10 days before the date of the workshop, in order to receive full tuition credit.
/Y
Please check the appropriate boxes:
CANCELLATION: Nikkei Horizons reserves the right to cancel a class, workshop, or tour if it does not meet minimum participation requirements, or cancellation of venue, or withdrawal of an instructor. A full refund or credit will be applied.
/Y
E-mail:
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Other Asian
I, the undersigned, am a voluntary participant in the Nikkei Horizons program of Keiro Northwest and I accept full responsibility for such participation.
/D
M:
New Student: Returning Student:
Chinese Japanese
By signing my name below I acknowledge and accept the risk and responsibility for my health and safety and waive to the fullest extent allowable by law any claim I may have for illness or injury against the program, its sponsoring organization, employees or volunteers, and against the facility housing the program.
Date: M
F:
/Y
Zip:
Name of Card Holder if different from above:
Please fill out and SIGN THIS WAIVER.
To the extent necessary, because of my health history and general physical condition, I have consulted my personal physician for advice and approval before participation and agree to obtain my own health or accident insurance to cover accidental injury or illness.
)
/D
CREDIT CARD PAYMENT REQUIRED INFORMATION. Please provide your email address for your receipt.
KEIRO NORTHWEST WAIVER & CANCELLATION POLICY I, the undersigned, am a voluntary participant in the Nikkei Horizons program of Keiro Northwest and I accept full responsibility for such participation.
Other #: (
Native American/Alaska Native
Please do not add me to the email list.
CVC: Start Date
)
Black/African American Latino
Billing Address if different: Expiration Date: M
City:
Address:
White
CREDIT CARD PAYMENT REQUIRED INFORMATION. Please provide your email address for your receipt.
Card #:
Birth Date: M
Select your race/ethnicity.
Language spoken at home:
Name of Card Holder if different from above:
Name:
Primary #: (
Select your race/ethnicity. White Black/African American Latino
Valid from Jan. 2019 - Dec. 2019
Please fill out and SIGN THIS WAIVER.
Signature: Emergency Contact Name:
In addition, I hereby consent to the use of my name, my photograph and or image by Keiro Northwest for the purpose of marketing and fundraising for Keiro Northwest and Nikkei Horizons. By signing my name below I acknowledge and accept the risk and responsibility for my health and safety and waive to the fullest extent allowable by law any claim I may have for illness or injury against the program, its sponsoring organization, employees or volunteers, and against the facility housing the program. CANCELLATION: Nikkei Horizons reserves the right to cancel clubs listed above if it does not meet minimum participation requirements, or cancellation of venue, or withdrawal of an instructor. A full refund or credit will be applied. WITHDRAWALS: Annual memberships are not refundable even if you withdraw.
Date: M Relationship:
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911 will be called in the event of an accident or medical emergency.
Emergency Contact #:
Nikkei Horizons • A Community Enrichment Program of Keiro Northwest
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Non-Profit Org U.S. Postage PAID 1601 E. Yesler Way Seattle, WA 98122-5640
Seattle, WA Permit No. 118
(206) 726-6469 / 6501 • 1601 E. Yesler Way, Seattle, WA 98122 • www.keironorthwest.org