WORKSHOP Entry Form

"Mario Robau Intensive" Registration
April 25-27, 2008 - $300 per per person
It is best to sign up with a partner, but if you sign up as a single, we will do our best to find one for you.
When submitting, please mail your check to the address below WITH THIS FORM, unless other arrangements have been made.

PARTICIPANT 1...
Name:
Cell Phone: Home Phone:
Email:
What is the best method to reach you in case of emergency cancellation?

PARTICIPANT 2...
Name:
Cell Phone: Phone:
Email:
What is the best method to reach you in case of emergency cancellation?

I do not have a partner, and would like you to find one for me.

PAYMENT...
   We will send our payment for::
     One Person - $300
     One Couple - $600
Space is guaranteed only for pre-paid couples. Payment must accompany this registration form.

I would like information on hotel accommodations:

PLEASE PRINT THIS PAGE AND SEND IT WITH YOUR PAYMENT.
Checks should be mailed to: "Dancing for Life"...6308 South Birch Ave...Broken Arrow, OK 74011

Comments:

NOTE: IF YOUR SUBMIT WAS SUCCESSFUL,
YOU SHOULD RECEIVE A CONFIRMATION PAGE.
YOUR ELECTRONIC ENTRY ALERTS ME TO EXPECT YOUR PAYMENT.