2017 Dance/Waltz Registration
ONE participant per registration

WALTZ
w/Sal Angelo @ OTIS TOWN HALL, One North Main Road, Otis/AGES 16+
10/5/17—10/26/17, Thursdays, 6:30-7:45PM

Couples welcome and limited number of "Single" slots

Graceful and elegant. A smooth progressive dance characterized by long, flowing movements, continuous turns, and rise and fall.
(appropriate shoes must be worn, leather-soled shoes preferred, no sneakers)

Registration closes 9/28/17, payment due at registration. Payment must be received within one week from date of registration, if not you will not be registered for the program.

Otis Residents/Otis Taxpayers $14, Non-Otis $24

Refund/Cancellation Policy:
Cancelled by Recreation Commission, 100% refund
Cancelled by Participant prior/on the registration close date = 100% refund
Cancelled by Participant after the registration close date = 0% refund

Payments are held until the first class, then deposited.

Sponsored by: Otis Recreation Commission
70 North Main Road | PO Box 237, Otis, MA 01253
413/269-4541 | otisrec@verizon.net | www.noticeotis.com

Participant's First Name
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Participant's Last Name
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Participant's Date of Birth
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Residential Address - Street, City, State & Zip
Street Address, City, State, Zip
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Mailing Address
PO Box/Street Address, City, State, Zip
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Emergency Contact Person & Phone Number
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Please list any health conditions and injuries that might affect your participation in the program: (if none, write "none")
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Phone Home
413/XXX-XXXX
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Phone Cell
413/XXX-XXXX
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Email
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Please include the email address I have provided for future emails:
Program
Fee (Waltz)
Registration closes 9/28/17, payment due at registration. Payment must be received within one week from date of registration, if not you will not be registered for the program. Fee may be mailed or dropped off at the Rec Center - PO Box 237, Otis, MA 01253 OR 70 North Main Road, Otis, MA .
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