1. TREASURE VALLEY COUNTRY WESTERN DANCE ASSOCIATION
JUNE 12, 2010
WORKSHOP REGISTRATION
Joe Tschirhart, Instructor
Boise Square and Round Dance Center
Name #1
Name #2
Address
Phone
Email #1
Email #2
Time Description On/Before 6/1 to Qty Subtotal
5/31 6/11
All Five Classes $30 $35
10:00-11:00 Beginner-Beginner Plus Nightclub 2-Step ($10)
Individual classes payable at
11:15-12:15 Intermediate Nightclub 2-Step ($10) door
1:30-2:30 Waltz ($10)
2:45-3:45 Beginner-Beginner Plus Country 2-Step ($10)
4:00-5:00 Intermediate Country 2-Step ($10)
($40 for all 5 classes at door) Total
Free Dance 7:00 to 11:00 - For dancers of all ages - No registration required
Make out check or money order to: TVCWDA-Randy Lattimer
Mail to:
TVCWDA
102 SW 8th Ave.
Meridian, ID 83642
LIABILITY WAIVER: I/we agree to hold the organizers of this event and their agents, harmless from suits, claims and demands
of every kind and character arising out of and in conjunction with this event. We hereby authorize the reproduction, sale,
copyright, exhibition, broadcast, and/or distribution of any event videotape without limitations. We understand the physical
risks associated with dance competition and social dancing, and assume full responsibility for any injury or personal damages
resulting from the TVCWDA Workshop 2010. All participants under the age of 18 MUST have the signature of their parent or
legal guardian.
Lady (or legal guardian if under18) Date:
Gent (or legal guardian if under18) Date:
For Staff use only:
Registration Rec’d Date___________________ E-mail confirmation date___________________ Entered into Database________
Check #____________________ Cash $____________________ Paypal $____________________ Confirmation #
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