Camp Blues - Winter Edition 2017
Registration Form
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Phone Number
Your answer
Country *
Your answer
Scholarship
Volunteer
When are you planning to arrive?
Your answer
Bedding
Are you able to provide housing for other campers?
Do you need housing?
What are your food restrictions, if any?
Your answer
What are your activity restrictions, if any?
Your answer
How many immersions/camps have you attended before?
Your answer
What is a brief history of your dance experience/background?
Your answer
Why are you attending this event?
Your answer
What do you hope to get out of your immersion experience?
Your answer
How did you hear about this event?
Your answer
Payment
Make your payment for the event here:
https://squareup.com/store/dancemode-brenda-russell/

You can also pay via PayPal to { brenda.dancemode@gmail.com }

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