Registration Form
Please print out and mail to
Congolese Dance and Drum Workshop
c/o Cai Sorlien
2500 Pike City Rd
N. San Juan CA 95960
Phone: 530-288-3603
Be sure to include ages for any children or youth being registered to ensure the correct fee.
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About You
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Gender __________________________________________ Mailing Address_______________________________________________________________________ City___________________ State _______________ Country ________________ Code (e.g.,zip)___________ Emergency Contact_______________________________________________________________________________
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About Your Stay
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| Are you staying for the entire workshop? | Yes___No__ If No, how many days are you staying?______ |
| What is your primary interest? Please Check One. |
_____Beginning Dance _____Intermediate/Advanced Dance _____Beginning Drum _____Intermediate Drum_____Advanced Drum _____Voice _____Kisansi |
| What are your dietary needs? Please Check One. |
_____Chicken _____Fish _____Vegetarian _____Non-Dairy _____Meat _____No special requirements |
| Please note any other special needs we should be aware of |
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About Others in Your Group Please provide information about all members of the groupNote: If this is a Group Registration (10 or more adults), please contact us directly |
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| Name |
Age if under 18 |
Primary Interest (See list above) |
Dietary Needs (See list above) |
Return to Main Registration Page for payment and other information