Master Jose Johnson visits Pittsburgh for the Living Masters Series for the first time to teach Silk Reeling Qigong and More – Workshop Registration Sept. 13-15, 2019 RM_StatsFirst Name *Last Name *Street Address *City, State Zipcode *Email *Emergency Phone *Waiver *I knowingly and voluntarily submit my registration for the One Pine Institute Living Masters Workshops, owned by One Pine Institute LLC and sponsored by Still Mountain T’ai Chi and Chi Kung LLC. I certify that I am in good health and assume all risk of physical and mental injuries, disabilities, and release One Pine Institute and Still Mountain T’ai Chi and Chi Kung, its agents, officers, representatives, sponsors, volunteers, and all other related members from all claims, actions, suits, and controversies at law by reason of a matter or cause sustained by me as a result of or in connection with my participation in the workshops. I understand that participation in the workshops, especially but not limited to forms practice, weapons practice, and reaction skills, entails a risk of injury, and I assume full responsibility for my actions intentional or otherwise. I fully understand that any medical attention or treatment afforded to me on site will be of a first-aid nature only, and I release its agents, officer, representatives, sponsors, volunteers, and all other related members from any liability from such aid. I consent that any pictures or videos furnished by me or taken of me at the workshops can be used for publicity, promotion, or media showing now or in the future and I waive compensation in regards thereto. I have read and fully understand the rules, regulations, and general information published by the workshops and agree with them in their entirety. I understand that I may be dismissed from the workshops for unsportsmanlike conduct without refund of any fees.I have read and fully understand the following waiverSIGNATURE (or Parent/Legal Guardian if participant is under 18) *Date *Select a payment method * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.