Registration Form
Print
out and send registration form and payment to:
Melissa McParland
12 Armell St.
Huntington Station, NY 11746
Please contact
Melissa at 631-385-1401 or e-mail mystique@nanikaihula.com if you have any
further questions.
Circle all that apply
and write the number of tickets that you are purchasing for the show.
|
Workshops |
Prices |
Number of registrations/tickets |
Price |
|
|
Workshop 1 -with Mystique |
|
$40 |
|
|
|
Workshop 2 -Hula |
|
$40 |
|
|
|
Workshop 3 - Beginner
Belly Dancing |
|
$15 |
|
|
|
Workshop 4 - JeniViva |
|
$45 After
3/8/10 =
$50 |
|
|
|
An Evening at the Oasis Show |
|
$25 |
|
|
|
|
|
|
Total
= |
|
Name
___________________________________
E-mail
___________________________ Phone_____________________________
Address_____________________________________________________________
Please pay by check made out to Melissa McParland.
All checks must be received by March 9th 2010.
All registrations and
tickets purchased after that date must be made in cash. After the 9th
call ahead to secure a spot.
In order to participate please sign the following consent: I
agree to release Desert Wind, Melissa McParland (Mystique), JeniViva, Dance
Aloha, and Christ Lutheran Church from any liability whatsoever in the unlikely
event I injure myself and/or others by participating in the workshops and show.
Belly dance is an athletic art form, and I assume full responsibility for any
risks, injuries, or damages, known or unknown, which I might incur by
participation in this event.
Signed__________________________________________Date__________________________
Do you want to Dance in the Evening Show? No
Yes – I want to dance
in the show and I am registered for at least one class and have purchased a
ticket for the Evening at the Oasis
Show - Fill out the next page.
An
Evening at the Oasis Dancer Registration Form
Name:
________________________________Phone Number: ___________________
Address:
______________________________________________________________
______________________________________________________________________
E-mail
__________________________________
Dancer/Troupe
Name(s):__________________________________________________
Title of Song/ Length of Song (up to 6
minutes) _______________________________
Dance style including any props to be used:
__________________________________
Description/Introduction___________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
_____________________________________________________________________
During
the show there will be videotaping. This video recording is strictly for
archival use and will not be distributed, sold
for viewing or published on the Internet. If you do not wish to be recorded
please let us know now.
___________________________________________________________________