Community Enrichment • Fall 2018 • 秋学期
Nikkei Horizons
CLASS SCHEDULE HOKKAIDO WINTER FESTIVALS AND NEW 2019 TOURS! page b
HOW OUR GUTS CHANGE WITH AGE AND GI ANATOMY page f © YASUFUMI NISHI | ©JNTO
MIZUHIKI BROOCH WORKSHOP page f
MOVE YOUR STUFF, TRANSFORM WITH FENG SHUI page e
MEMBERSHIP CHANGES COMING IN 2019 All current Nikkei Horizons Memberships have been extended through Fall quarter 2018! See page d for details.
SEE THE WORLD WITH NIKKEI HORIZONS Tour Orientations will be scheduled in October and November 2018. Please contact Rie Taki, Nikkei Horizons Travel Supervisor for detailed information.
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New 2019 Tours
HEART MOUNTAIN JUNE 2019
Save your spot at orientation! RSVP at: nhinfo@keironw.org | 206.726.6469 (direct)
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HOKKAIDO WINTER FESTIVALS JANUARY 29 – FEBRUARY 9, 2019
Please see details on page d.
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MLB MARINERS OPENING GAME AND SUMO IN JAPAN! MARCH 2019
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, Amano Hashidate, one of the three best scenic views in Japan, and unique experiences sightseeing in Osaka, Kyoto and Tokyo. Limited spaces!
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HISTORIC TRAILS AND THE GREAT SMOKY MOUNTAINS MAY 2019
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ULTIMATE JAPANESE SUMMER FESTIVALS AUGUST 2019
Breathtaking summer is waiting for you in Japan! This experience is back by popular demand from our successful 2019 tour. Exclusive access at Aomori Nebuta and Akita Kanto Festivals. Breathtaking viewing at Nagaoka Grand Fireworks Festival! Limited spaces!
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Discover the heart of the Appalachian Mountains and visit some of America’s most iconic sites! Highlights include: Gettysburg, National Parks, the country Music Hall of Fame and more!
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Join us on a journey of heart wrenching history as we travel from Salt Lake City, UT to Rapid City, SD. Visit sites such as Heart Mountain Relocation Center, Mount Rushmore, Crazy Horse, Yellowstone, the battle site of Little Big Horn and more!
EUROPEAN DISCOVERY – FOLLOWING ON THE FOOTSTEPS OF 442ND SEPTEMBER 2019
Join us on a wonderful and informative journey through Italy, Switzerland and France. Along the way visit several of the sites where brave Nisei soldiers fought in World War II.
(206) 726-6469 / 6501 • 1601 E. Yesler Way, Seattle, WA 98122 • www.keironorthwest.org
New 2019 Tours
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ITALY, CROATIA AND GREECE CRUISE OCTOBER 2019
aboard a luxury boat on Halong Bay. Find inspiration at Cambodia’s Angkor Wat temple, learn the history of the notorious Khmer Rouge, and journey on the Mekong River.
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This tour includes a one-day, pre-cruise stay in Rome before setting sail on Holland America featuring excellent cabins with private balconies. Enjoy local tours in Dubrovnik, Kotor, Corfu, Katakolon (Olympia), Santorini, Athens and Pompeii.
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WONDER OF CHINA & THE YANGTZE RIVER NOVEMBER 2019
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.
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KINGDOMS OF SOUTHEAST ASIA - VIETNAM, CAMBODIA AND LAOS NOVEMBER 2019
CHRISTMAS MARKET TOUR DECEMBER 2019
Prague, Vienna, Salzburg, storybook German villages and the Alps. A fantastic way to experience some of the best scenery in Europe. Taste the sights and sounds of this magical time of the year in some of Europe’s prettiest towns and villages. This is an unforgettable tour!
LIVE IN SPAIN! FEBRUARY, MARCH 2019
Get away this winter and enjoy a wonderful month or two on Spain’s Costa del Sol. Enjoy a comfortable, pre-furnished, one-bedroom apartment near Torremolinos within walking distance of the sea. Enjoy a welcome meal and orientation tour to the city and live like a local with the comfort of weekly guided tours during you month-long stay. Airport transfer to and from the airport in Spain provided.
Explore Southeast Asia as you learn culinary secrets in the ancient town of Hoi An and cruise overnight
Nikkei Horizons • A Community Enrichment Program of Keiro Northwest
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ADVENTURES 2019 HOKKAIDO WINTER FESTIVAL TOUR (Only a few spots left)
LUNCH BUNCH Make new friends and try different restaurants around the Puget Sound area. The first stop on this series is RE: PUBLIC Restaurant and Bar, a farm to table style restaurant, which was voted #1 in Western Seattle by King 5 Evening Magazine. Please indicate on your registration form which dates you will attend. Participants pay for their own meals at the restaurant. Wednesday, September 19 and October 17 11:00 am – 2:00 pm (or TBD) Seattle Buddhist Church Parking Lot • 22 Person Limit Annual Member $20 per single outing • $40 for two outings
© YASUFUMI NISHI | ©HOKKAIDO TOURISM ORGANIZATION | ©JNTO | JTB USA, INC
Enjoy a winter wonderland in Hokkaido! In JanFeb, 2019, Nikkei Horizons is offering a winter Hokkaido tour. Destinations include Asahikawa, Sounkyo, Abashiri, Teshikaga, Kushiro, Shikaribetsu, Tokachigawa, Shiraoi, Sapporo and Otaru. Come and enjoy the world-renowned Sapporo Snow Festival, Ice Breaker Cruise, Japanese Red Crown Crane, Ice Festival, Ice Bar, local cuisine, hot spring, local culture and more! Tuesday, January 29 – Saturday, February 9 Price for 12 days 10 nights (land only): $5,495 pp/ double occupancy • $6,720 pp/single Tour deposit: $500 upon registration Air Reservation by ANA: Please contact Rie Taki at 206-726-6469
Non Annual Member $25 per single outing • $50 for three outings (Includes transportation and expenses for driver and escort) 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.
MEMBERSHIP CHANGES COMING IN 2019! Dear Community, Thank you for your support and participation with Nikkei Horizons, a Community Enrichment Program. For almost 30 years we have offered classes, travel and events that engage and inspire. We will be making some changes to annual memberships coming in 2019 but all current annual memberships have been extended through the end of Fall Quarter 2018! Starting January of 2019, annual memberships will move to a calendar-year annual basis. This change reflects the future of Nikkei Horizons offerings that will coincide with seasonal and annual events rather than following an academic year calendar.
We hope these changes will make your experience of Nikkei Horizons even better and we hope to build on our legacy while continuing to enrich the lives of those we serve. You will receive additional information toward the end of this year in November but in the meantime please enjoy your extended membership and have a great fall quarter! See you in class! Warm Regards, Your Horizons Team Linda Asami, Classes & Events Rie Taki, Travel & Adventures Jake Colter, Director
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! HOW OUR GUTS CHANGE WITH AGE AND GI ANATOMY From entry to exit, the gastrointestinal tract is approximately 30 feet long. This mulit-tasking tube is full of twists, turns, bumps, and fluids that do more than simply break down food and remove waste. Join us as we learn about this (usually) one-way track and how it changes over time.
OVEREXPOSURE TO ANTIBIOTICS, HOW IT EFFECTS ALL OF US At its first discovery, it was considered the drug that would put an end to all disease. Almost a hundred years later, we're finding more and more illnesses that are resistant to its effects. Antibiotics, why wasn't it able to end all disease? And how is its overexposure effecting our health today? From super bacteria to how our food is processed, find out how antibiotics may actually be making us sicker. Rolando Fulgencio, ND Wednesday, October 10 • 10:30 am – 12:00 pm Keiro Northwest • 20 person Limit Annual Member FREE • Non-Annual Member $10
MOVE YOUR STUFF, TRANSFORM WITH FENG SHUI
Lindsey Brentin, RN Iora Primary Care Thursday, September 20 • 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 SUN
MIZUHIKI PIN MAKING WORKSHOP What makes you happy? Do you collect tea cups? Or little figurines? Everyone has things that brings a smile to your face. Do you need to spruce up your home or do you just want to learn some amazing and practical decorating tips? Sometimes, your favorite things begin to look like clutter when you don't know how to display them properly. Learn to transform your living space by placing your favorite things in an organized and beautiful manner.
Using mizuhiki cords we will create pins, easy for beginners. Bring scissors, small wire cutters & needle-nosed pliers if you have them available. Bring any small buttons (3/4”-1”) to use for center of flower pin. Please pay $5 materials fee for supplies to the instructor. Kathy Carmichael & Rebecca Durham Sunday, October 7 • 1:00 pm – 3:00 pm Midori Condos • 10 Person Limit Annual Member $15 • Non-Annual Member $25 (Please pay $5 materials fee to the instructor at the class)
Jenny Hones www.ThreeFrogsDesign.com Thursday, October 11 • 10:30 am – 12:00 pm Keiro Northwest • 20 Person Limit Annual Member FREE • Non-Annual Member $10 ICON KEY
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Nikkei Horizons • A Community Enrichment Program of Keiro Northwest
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LIVING INDEPENDENTLY LONG TERM CARE PLANNING Does your financial plan address potential Long Term Care (LTC) concerns and needs? Do not wait until a crisis happens to discuss Long Term Care. This workshop will cover: Evaluating the Need for LTC Insurance, Alternatives to Traditional LTC Insurance, Medicare’s Limitation, Medicaid’s Role in LTC, and much more! Jon Alejandro Heartland Institute of Financial Education Tuesday, October 9 • 10:30 am – 12:00 pm Keiro Northwest • 20 person Limit Annual Member FREE • Non-Annual Member $10
MEDICARE UPDATE BY CHO SHIMIZU How will Medicare affect you? Cho Shimizu from SHIBA (Statewide Health Insurance Benefit Advisors) will explain Medicare changes. Preventative services, durable medical equipment, and drug issues, along with Medicare changes to health insurance, will be discussed as part of this workshop. Those with drug issues should bring a list of drugs taken. Q&A time follows, so bring your questions to the class! **Two locations—please specify of the date and location when you register** Cho Shimizu Location 1: Tuesday, October 30 • 10:00 am – 11:30 am Keiro Northwest 20 Person Limit FREE for Annual Member • $10 for Non-Annual Member
ums. 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 Tuesday and Thursday, October 23 and 25 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.
WHAT HAPPENS AFTER THE PAYCHECKS STOP? What happens after the Paycheck stop? We will discuss income during retirement and explore how to budget for retirement expenses, examine potential sources of retirement income and identify ways to address potential risks Chiaki Hirate, AAMS ® CRPC® Edward Jones Tuesday, November 6 • 10:30 am – 12:00 pm Keiro Northwest • 20 Person Limit Annual Member $10 • Non-Annual Member $15
Location 2: Wednesday, November 7 • 10:00 am – 11:30 am White River Buddhist Temple 3625 Auburn Way North, Auburn WA 98002 20 Person Limit FREE for Annual Member • $10 for Non-Annual Member
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 premif
(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, October 2– November 20 (8 weeks) 1:00 pm – 3:00 pm Nikkei Manor • 12 Person Limit Annual Member $35 • Non-Annual Member $45
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, September 12 – November 14 (10 weeks) 10:00 am – 12:30 pm Midori Condos • 10 Person Limit Annual Member $43 • Non-Annual Member $53
COMPUTERS ORIENTATION TO THE ANDROID SMART PHONE AND TABLET Your instructor will guide you through the basics of using your Android smart phone or tablet. Topics will include connecting to Wi-Fi, using maps, text messaging, calling, and basic web browsing. Class will rely on the AARP Technology, Education and Knowledge videos which you can re-watch on your own. Prerequisite: Please bring your fully charged smartphone/tablet to class with you. Free Wi-Fi will be provided during the class.
Owen Takagi Thursdays, November 1 and 8 10:00 am – 12:00 pm Keiro Northwest • 10 Person Limit Annual Member $30 • Non-Annual Member $40
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, September 11 – November 13 (10 weeks) (New time for this quarter only) 11:35 pm – 12:35 pm Seattle Buddhist Church Gym • 30 Person Limit Annual Member $43 • Non-Annual Member $53
ADVANCED TUESDAY TAI CHI This class by Edward Wan is for students continuing or experienced students with Yang Family style Tai Chi. Edward Wan Tuesdays, September 11 – November 13 (10 weeks) (New time for this quarter only) 12:40 pm – 1:40 pm Seattle Buddhist Church Gym • 30 Person Limit Annual Member $43 • Non-Annual Member $53
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.
Nikkei Horizons • A Community Enrichment Program of Keiro Northwest
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Yu-San Gartz Mondays, Wednesdays, and Fridays, September 10 – November 19 (10 weeks / 30 classes, no class November 12) 11:00 am – 12:00 pm Seattle Buddhist Church Gym • 35 Person Limit Annual Member $70 • Non-Annual Member $80
YOGA FOR HEALTHY AGING Throughout the quarter we will practice Yoga for Strength, Flexibility, Balance and Agility; important physical skills for staying healthy and independent as we age. We will also use these skills to cultivate cardiovascular health, brain health and reduce chronic stress. We will also practice cultivating equanimity: learning how to manage stress, maintain emotional stability and learn new ways of thinking about our lives. All classes will consist of Asana (yoga poses), Pranayama (breath practices) and Meditation. Yoga poses will include variations and options for using props, making the class accessible for everyone. Welcome for all levels of students including beginners. Please bring to class: a yoga mat, blanket, 2 blocks yoga strap (or scarf or belt) and a full water bottle. Cindy Jaffe Wednesdays, September 12 – November 14 (10 weeks) 12:30 pm – 1:30 pm Seattle Buddhist Church Dining Room • 20 Person Limit Annual Member $60 • Non-Annual Member $70
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 2018-2019 Annual membership until August 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 Annual Memberships extended through Fall Quarter! FREE to attend for all members.
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FINANCE NIKKEI HORIZONS INVESTMENT CLUB Join other investing beginners to research, buy hold and sell investments. Participation of club is expected. National Association of Investors Corporation (NAIC) 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 Annual Membership (valid Sept 2018 – Aug 2019) when you register. Chiaki Hirate 1st Wednesday of the month – September 5, October 3. November 7 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. Pat Kono Thursdays, September 13 – November 15 (10 weeks) 9:30 am – 11:30 am Nikkei Manor • 12 Person Limit Annual Member $43 • Non-Annual Member $53
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, September 17 – November 5 (8 weeks) 1:00 pm – 2:30 pm Midori Condos • 20 Person Limit Annual Member $38 • Non-Annual Member $48
(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9月8日、10月13日、11月10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 2017-2018 Annual membership until August 31, 2018.
and some Hawaiian language while enjoying the essence of Hawaiiana. This class fits all levels. Beginners are welcome. Joey Hendrickson Wednesdays, September 12-November 14 (10 weeks) 12:30 pm – 1:30 pm Seattle Buddhist Church Gym • 25 Person Limit Annual Member $43 • Non-Annual Member $53
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.
Yoko Sato 1st Thursday of the month – September 6, October 4, November 1 1:30 pm – 3:30 pm Midori Condos • 20 Person Limit FREE with Annual Membership (required)
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!
MAHJONG CLUB
Supplies needed: brushes, ink stick, ink stone, sumi paper, water cup, paper towels
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 2017-2018 Annual membership until August 31, 2018.
Midori Kono Thiel Mondays, October 1 - November 19 (7 weeks, no class November 12) 1:00 pm – 3:00 pm Seattle Buddhist Church Dining Room • 10 Person Limit Annual Member $34 • Non-Annual Member $44
1st and 3rd Wednesdays 1:00 pm – 3:00 pm
MIZUHIKI ZAIKU — ADVANCED LEVEL
Kin On Community Center 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
SUMI-E BRUSH PAINTING
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, September 13-November 15 (10 weeks) 9:30 am – 11:30 am Midori Condos • 15 Person Limit Annual Member $43 • Non-Annual Member $53
Nikkei Horizons • A Community Enrichment Program of Keiro Northwest
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CLASS LOCATIONS
CANCELLATION POLICY
Iora Primary Care (New Location) 306 23rd Avenue S., Seattle, WA 98144 (206) 518-9033
CANCELLATION
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
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.
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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.
オンライン登録受付中！ www.keironorthwest.org からオンライン登録ページ へリンク。健康的で活気ある生活を応援するクラスや特 別企画の旅行など、世代を超えて楽しめる教育プログラ ム。日本語クラスは、 「NIHONGOと入力して検索して下 さい。
(206) 726-6469 / 6501 • 1601 E. Yesler Way, Seattle, WA 98122 • www.keironorthwest.org
FALL QUARTER 2018 REGISTRATION • 登録用紙 Please PRINT, one registration form PER PERSON. This form may be duplicated. Name:
Birth Date: M
Address:
City:
Primary #: ( )
Other #: ( )
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F:
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M:
New Student: Returning Student:
Zip: E-mail:
Cell #: ( ) OPTIONAL Select your race/ethnicity.
White Black/African American Latino
Chinese Japanese
Other Asian Mixed race (check all that apply)
Native American/Alaska Native
Vietnamese
Korean
Other race/ethnicity Language spoken at home:
CREDIT CARD PAYMENT REQUIRED INFORMATION. Please provide your email address for your receipt. Name of Card Holder if different from above: Card #:
Billing Address if different: Expiration Date: M
Class/Tour Title
Please do not add me to the email list.
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Location
Start Date
Please make checks payable to: KEIRO NORTHWEST Mail a check with completed registration form to:
$10 Membership fee valid through December 31, 2018
NIKKEI HORIZONS 1601 E. YESLER WAY, SEATTLE, WA 98122
Donations are appreciated to help maintain programs.
Session/Time
Fees/Tuition
(Membership fee $10) Donation to Nikkei Horizons Total Amount
KEIRO NORTHWEST WAIVER & CANCELLATION POLICY Please fill out and SIGN THIS WAIVER. I, the undersigned, am a voluntary participant in the Nikkei Horizons program of Keiro Northwest and I accept full responsibility for such participation. 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. 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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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 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. 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, in order to receive full tuition credit.
Date: M Relationship:
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911 will be called in the event of an accident or medical emergency.
Emergency Contact #:
(206) 726-6469 Nikkei Horizons / 6501 • 1601 • A Community E. Yesler Way, Enrichment Seattle, WA Program 98122 •of www.keironorthwest.org 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