Print form, complete and mail to address at the bottom. Please feel free to copy this registration
form as needed.
Name:
Address:
City,
State/Province:
Zip/Postal Code: Telephone:
E-mail address:
Club Name:
Teacher’s Name:
Your dancing level (Circle one): 1 2 3/4 Please ask your teacher what level
you
should be in if you have any questions.
Pre-reg.* #
of Total $
US(CAN at par) Persons Amount
Ceilidh –
Adult $7.00
Ceilidh –
Student $5.00
Workshop –
Adult $20.00
Workshop –
Student $10.00
Ball –
Adult $25.00
Ball –
Student $20.00
Ball –
Spectator $15.00
Grand
Total:
*
Workshop and Ball prices $5 more at the door.
Confirmation Packet
Please indicate how you
would like to receive your confirmation packet:
o Email o Postal Mail
Please make check payable
to BSCD. Mail form and registration fee
in US or Canadian (CAN) dollars to:
Registrar Questions? Contact the Registrar