Registration for:

Introduction to Middle Eastern Dance

Special Workshop

Saturday January 6, 2007

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

Mirah Ammal

 

Mail to: Mirah Ammal

Attention: Introductory Workshop

P.O. Box 19342

Minneapolis, MN 55419

 

Credit card or bank payments also accepted through PayPal. Email your registration information to mirah@mirahammal.com, referencing PayPal to receive an email invoice and instructions.

 

Yes, I would like to register    

Number of students

  

x    $20.00

Total amount enclosed

  

 

Waiver statement: "I hereby state that I am registering for a dance workshop with instructor Mirah Ammal, 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 Mirah Ammal, and assigns acting on their behalf, arising directly or indirectly from my participation in any such aforementioned activities."

Name
Address
 
City, State and ZIP
 
Email
 

Phone (to contact in case of cancellation or questions regarding your reservation.)
 
Signature indicating that you have read and understood the waiver                                                  Date

 

Other Important Information

  • This workshop will be taught at Sabathani Community Center in the Dance Studio, at 310 E. 38th Street, Minneapolis (two blocks east of 35W.)

  • Register early - for the comfort and enjoyment of all students, enrollment is limited.

  • Mirah Ammal assumes 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 must sign the waiver statement above, acknowledging that participation is at their own risk and that the above parties are not liable for injury, theft, or loss of property. 

  • Adult students of all ages are welcome. Students between the ages of 16 and 18 must have a release and permission form signed by a parent or legal guardian on file for each class session. Students under the age of 16 must be accompanied by a parent or guardian at all times.