Presented by Canyon Movement Company and Canyon Dance Academy.        

                                               
July 18-22  2011

Sunday July 17th evening orientation 7-9 pm 

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REGISTRATION FORM (Copy and paste into a word document, print it and MAIL WITH CHECKS PAYABLE TO:

Canyon Movement Company

5680 East Sunset Drive

 Flagstaff, Arizona 86004

 
Once payment is received a detailed schedule will be sent to each registrant.  

 For questions call 928.774.3937   or email  canyondance@live.com

 

Workshop Fee — $400 before May 1, $425 after May 1 (limited space available)

 T-shirt - $15  Size __________ (pre-orders only)

 

Total enclosed: $_________________  Payment plan available

       

Name                                                                              Age :                              

Parent's name (if applicable)                                                                                 

Email:                                                                                                                    

Address:                                                                                                                

City, State, Zip:                                                                                                     

Phone number:                                             Alternative #                                    

Emergency contact:                                      Phone number:                                  

 Due to the physical nature of dance, I agree to hold harmless Canyon Dance Academy, Canyon Movement Company, S&G Property Management, and/or any instructors at this studio for any accidents or injuries which may occur while taking classes here, whether they happen in class, before or after class, in performance, and/or in an alternative space.

Signature  ______________________________________________Date _________

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