PRINT A REGISTRATION FORM
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Please Select Your Interests: ___$25 for Drum Class Only ___$20 for Dance Class Only ___$40 for both Drum & Dance Classes ___$35 Early Bird Registration for both classes (payment due by 4/25/09) ___ I need to reserve a drum!
Registration Form: Please Print All Information Clearly Name: __________________________________________________ Phone: ____________________________ Address: _____________________________________________________________ City: ____________________________ State: _____________ Zip: _____________ Email: _______________________________________________________________ Please make check or money order payable to Tim Touhey. Mail registration form and payment to the address above.You can pay in advance weekends at The Gallery 607 652 4030 to meet. 12pm to 6pm
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copyright © 2002 2004Timothy Touhey