Registration Form Maysameh Workshops & Gala Belly Dance Fusion Show
June 13 Bollywood Workshop, June 13 Gala Show, June 14 Tribal Workshop
Print or copy, then email or Mail to iworldartists.com, 5809 Cameo Glass Way, Raleigh, NC 27612 or
email amaraalamir@amaraalamir.com
(919) 803 0931
Name______________________________________Performing Name______________________________
Address, City, State, Zip________________________________________________________________________
Phone; home and cell______________________________________________________________________
Email________________________________________________________________________________________
Workshop Participants have preference...No guarantee...based on first paid, first dance
Dance Description (Limit 3-4 Min Solo) (Professionals & Groups 5 Min)___________________________________
_____________________________________________________________________________________________
Music:______________________________________Costume_________________________________________
Instructions: Stage On or Off Stage, End on or Off Stage_____________________________________________
# of Participants 6/13 Bollywood_______________ # of Participants 6/13 Tribal______________________
Teachers Free w/4 Students # of Students______________________(must be paid in one check)
# of Show Attendees 6/13_____________________ Names _______________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
Early Bird Special Both Days &75 (By 5/15/09)
Workshops $45 Each ($55 Door) Two Days $100
Teachers Bringing 4 Students Free Workshops (Teacher collects and pays for all at once)
Amount Enclosed or will be paid_______________________________
Expected Method of Payment; Check Mailed________________Credit Card__________________Paypal__________________
www.paypal.com; send funds to amara@iworldartists.com