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Registration for:

Spectacular Shimmies and Layers Workshop

~ and ~

Fire and Ice Hafla Show

with Mirah Ammal, hosted by Zahra Sagira

Saturday February 28, 2009

Print this registration page and mail with a check, payable to

Aalim School of Dance

Complete the form through to the signature line, which will print on page 2. BE SURE TO READ ALL POLICIES.

(Trouble printing this page? Click here for .pdf version. <- Link temporarily disabled)

 

Mail to: Mirah Ammal

Attention: Workshops

P.O. Box 19342

Minneapolis, MN 55419

*Note all events for the February 28 workshop and the Fire & Ice Hafla are held at the Lion's Club in Wauwatosa, Wisconsin, but registrations are being processed by Mirah's Aalim School, based in Minneapolis. This is why the advanced registration mailing address is Minneapolis.

 

Quantity

   Fee

Spectacular Shimmies & Layers Workshop

11:00 a.m. to 2:00 p.m.

   $35.00

Tickets to the Fire and Ice Hafla

Doors open at 6:30, show begins at 7

   $5.00

Total

  

 

 

Are you 18 or older?

 

    Yes

 

Waiver statement: "I hereby state that I am registering for a workshop with Mirah Ammal and the Aalim School of Dance, LLC., and as such participate in the taking of dance instruction and related physical activities. I warrant that I am physically able to participate in such activities; however, I recognize the risks of injury inherent in such physical activities and I am participating in said activities and am doing so at my sole risk and hereby freely and voluntarily release, discharge, waive and relinquish on behalf of myself or any person claiming on my behalf, any and all claims actions or causes of action whatsoever, including acts of negligence, whether occurring during class or away from class time as it relates to class activities, for personal injury, property damage, costs, liabilities or expenses (including attorney’s fees and court costs) against Aalim School of Dance, it’s organizers and staff, dance instructors, and assigns acting on their behalf, arising directly or indirectly from my participation in any such aforementioned activities."

 

Please print legibly

Name
 
Address
 
City, State and ZIP
 

Phone (to contact in case of class cancellation or rescheduling due to illness, weather, etc.)
 
Email

I have read and understood the policies (below) and waiver statement (above), and hereby indicate my agreement and consent.

 

Signature of student or adult guardian (if student is under 18)                                                                     Date

 

Policies and Other Important Information

Please make checks payable to Aalim School of Dance.

Mirah Ammal and Aalim School of Middle Eastern Dance, LLC, its appointed instructors and substitutes, sponsors, and the studios assume no responsibility for injury, theft or loss of property incurred during the classes, workshops, performances or other participation in class or related activity. Each student is required to sign a waiver statement, and all students acknowledge that participation is at the student's own risk and that the above parties are not liable for injury, theft, or loss of property. 

No refunds will be made after February 21.