REGISTRATION FORM by jEAi786W

VIEWS: 7 PAGES: 1

									                                                Dance with Mike and Sanna
                                                                  Learn to dance
                                                          ballroom, country & latin
                                                           and have FUN too!!!

                                                            REGISTRATION FORM                                                     Session : FALL, Sept. 2012
Name: ( First)                         (Last)                                          Partner’s name


Email address:                                                                         Partner email:
print clearly

Tel No.          Home                     Work                         Cell            Tel No.       Home                   Work                          Cell


                      ** Please check(circle) location
        (New!)________North (Wed): Scandinavian Cultural Centre, 739 – 20 Ave NW, Calgary
                 ________South (Mon):               River Park Church, 3818 – 14A St SW,Calgary (near Marda loop,Crowchild & 33rd Ave)

                 North >> Class start date : Sept 12, 2012                    Class end date: Nov 28, 2012               (8 wednesdays+4 thursdays)
                 South >> Class start date : Sept 10, 2012                    Class end date: Dec 3, 2012                 (12 Mondays) **no class Oct 8,2012

            Level 1 - novice / beginner                            Never danced before & basic technique review
            Level 2 - beginner + intermediate                      Know the basic steps of the dances being taught

                                      Time (new 4 wks/dance)         Week 1 - 4              Week 5 - 8             Week 9 - 12
                   Level 1        |    6:45-8:15 p.m.                Cha Cha                 Waltz                  Rumba
                   Level 2        |    8:15-9:45 p.m.                Cha Cha                 Waltz                  W.C.Swing


Please check dances below & pay appropriate fees.                       Level 1 _____      Level 2 _____       Amount $ _________               Date___________

                                                                   (NEW 4 wks total 6hrs/dance)
    SOUTH- Mondays                NORTH- 8Wed +                 LEVEL 1                 LEVEL 2                    Rate/couple                 Rate/single
                                 4Thurs
 Sep 10, 17, 24 Oct 1            Sep 12, 20, 26 Oct 3           Cha cha                 Cha cha                      $ 100.00                    $52.00
 Oct 15, 22, 29 Nov 5            Oct 10, 18, 25, 31             Waltz                   Waltz                        $ 100.00                    $52.00

 Nov 12,19, 26 Dec 3             Nov 7,14, 22, 28               Rumba                    W.C.Swing                   $ 100.00                    $52.00
                                            Discounted fees for paying all 3 sessions>>>                             $ 290.00                  $150.00



** No refund on fees and we reserve the right to merge or cancel the class if minimum is not met**
Waiver
I agree that I hereby release and forever discharge Mike and Sanna Foreman from any and all actions, causes of action, claims and demands whatsoever in law or in equity
which I, my heirs, executors, administrators or assigns can, shall or may have reason of damage, loss or injury to my person or property howsoever caused, including negligent
acts. Which hereafter may be sustained by myself or arise as a result of receiving and taking any and all instruction from Mike and Sanna Foreman, or arising as a result of my
attendance at classes, workshops, social functions or other events as they may occur. I acknowledge that the nature of the services provided by Mike and Sanna Foreman are
physical in nature and I hereby assume full responsibility for my own health, safety and well-being.



_____________________________________                                    ______________________________                           _________________
Signature                                                                Partner’s Signature                                       Date

Please return this registration form + your cheque payable to: Sanna Foreman                                             (Note: NSF cheque fee $20.00)
Mail to: Sanna Foreman, 500, 906 – 12 Ave SW, Calgary, AB T2R 1K7
For more information, please call Sanna Foreman at (403) 620-8633, or email sannalam@gascan.ca
                                                        www.DanceWithMikeAndSanna.ca

								
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