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Registration Form Jim Boz Workshop June 6 - 7, 2009 |
Classes will be held at Sirrom. |
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Print this form and mail to: |
Sirrom School of Dance, PO BOX 270483, Houston, TX 77277-0483 |
Name Street Address City State Zip/Postal Code Home Phone
| Sirrom Special - Saturday and Sunday Workshop on or before 5/30/09 -- $115 (no SOS discount) | $______________ | |
| Sirrom Special - Saturday and Sunday Workshop after 5/30/09 -- $130 (no SOS discount) | $______________ | |
| Saturday class on or before 5/30/09 -- $75 ($67.50 for SOS member) | $______________ | |
| Saturday class after 5/30/09 -- $80 ($72 for SOS member) | $______________ | |
| Sunday class on or before 5/30/09 -- $50 ($45 for SOS member) | $______________ | |
| Sunday class after 5/30/09 -- $60 ($54 for SOS member) | $______________ | |
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Total Enclosed |
Payment method - Make checks payable to "Sirrom School":
Check Credit Card
Cardholder Name Card Number Expiration Date
I hereby release Sirrom School of Belly Dance, anyone associated with the studio, and the workshop instructor for any and all claims for damages or injuries which I/we may sustain while participating in any activity connected with the Seminar/Show. If registering for troupes and/or students, all need to sign the release. Thank you.
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Registration is non-refundable and nontransferable.
No Video Cameras are allowed at workshop and Gala Show.
People video taping without permission will be asked to leave and the admission will not be refunded.