REGISTRATION FORM

Country Dance Weekend, Oct.2-4, 2009
Name(s) ____________________________________

Address ___________________________________

City, State, Postal Code 
__________________________________________

Phone (day, evening) and E-mail _________________
__________________________________________
 

You may register full-time or for individual sessions. Advance registration for single events is not required. You may pay at the door.
We are an at-cost organization and our costs have risen greatly. The full time registration fee is suggested, but we ask you to pay what you can between $80 and $110.

#	Full-time registrations @ $100 (Sliding scale $80 to $110)	$
#	$5 late fee (after September 16)	$
#	Friday night Contra dance @ $12	$
#	Saturday morning English country workshop @ $21	$
#	Saturday afternoon English country workshop @ $21	$
#	Saturday night English country dance @ $30	$
#	Sunday morning Community dance  @$21	$
#	T-shirts: 100% cotton @ $15 each Red, purple, Blue, deep pink Size: S M L XL 2X	$
	Total Enclosed	$

__ I can OFFER/NEED hospitality for the weekend. (Circle one.)

Make checks payable to: Minnesota Country Dance Coop. If you include a stamped envelope, a confirmation letter with more details will be sent to you. Mail registration & self-addressed stamped envelope to:

George Ehrenberg
3932 15th Ave. S.
Minneapolis, MN 55407