Registration Form for Diamond State Line & Partner Dance Workshop
Saturday, March 26, 2011   Millcreek Fire Hall
9:00 am -  4:30 pm  Evening Dance 6:30-10 pm 

PLEASE PRINT: 

First Name:___________________________ Last Name:__________________________

 Address:_________________________________________________________________

 City:________________________________ State:___________ Zip:________________

 Phone: Day (         )_______________________ __Evening (        )___________________

Email Address:_____________________________________________________

 Submission of this form by the party listed above signifies the following statement:

  “I agree to hold the organizers of this event and their agents harmless from all suits, claims or demands of every kind and character arising out of or in conjunction with this event.  I understand the physical risk of social dancing and assume full responsibility for any injury or personal damages resulting from the event mentioned above. I certify that I am 18 years or older (applicable to Legal Guardian if under 18 years of age).”

Dance Experience:  Beginner ______    Intermediate_______    Adv._________
LUNCH can be bought the day of the event at the fire hall
If you are interested please check and then circle your choice   YES___________    NO_______________
Choice of Chef's Salad, Tuna Salad, Ham & Cheese or Turkey & Cheese
________________________________________________________________________________________________

Office Use Only

Type of Payment Received____________________________  Date Rec.____________

Cost is the same Low Price as previous two (2) years:
$40 per person if registration is received (not postmarked) by February 15, 2011
$50 per person if received on or after February 15, 2011  
Sorry, No Exceptions / No Refunds

Evening Dance:
The evening dance will be included in the cost of the workshop.
If you do not attend the workshop but wish to attend the evening dance, the cost will be $10                                               

Make all Checks or Money Orders payable to Joanne Brady
And mail to:  Joanne Brady  803 Partridge Court, Hockessin, DE 19707-1309  OR
Angela Crowl  2210 W. 9th Street, Wilmington, DE 19805

 Format for the day: Once the day begins we will teach a dance, then dance 2 or 3 social dances, then teach another, then dance 2 or 3 social dances and this format will continue throughout the day.  The last 30 minutes of the day will be a review of the dances taught during the day.  We want the day to be relaxed and fun so expect to be “flexible”.  This workshop is primarily a FUN workshop offering high beginner to low intermediate dances.