PRINT A REGISTRATION FORM

 

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

 

 

 

 

copyright © 2002 2004Timothy Touhey