Registration form

April Choreography Workshop with Helena and Yaro
April 9, 2011
The Fuse Dance Center, Binghamton, NY
    
$30 pre-pay by April 1, 2011,       $35 at the door
(cash only, at the door, please!)      


Name:  ________________________________________________  

phone:  ___________________________

email:  ________________________________________________   

cell phone:  _________________________

Address:  
___________________________________________________________________________________

Check amount:  $___________________       check number:  ___________________           


Please make checks payable to: J. H. Smart
Mail along with registration form to: Egyptian Twist Studio of Bellydance, 819 Stanley
Lake Rd., Friendsville, PA 18818

Teachers with 3 students receive 50% off,  with 5 students or more, receive workshop
for free!