Registration for Hossam & Serena Ramzy Events

***Registration for Hossam & Serena Ramzy Events***

Name:

Address (please include zip code):

Phone #: Home: Cell or Work:

E-mail Address:

Event Registering For: Friday Night Show/Party (workshop participant $20)

Friday Night Show/Party (general public $25)

2 Day Bellydance Workshop (Sat. & Sun $210)

Add $20 to fee if registering after 4/10/04

Saturday Bellydance Workshop ($120)

Add $15 to fee if registering after 4/10/04

Sunday Bellydance Workshop ($120)

Add $15 to fee if registering after 4/10/04

Video Lecture (workshop participant $10)

Video Lecture (general public $15)

Percussion Workshop (Bellydance workshop participant $110)

Add $15 to fee if registering after 4/10/04

Percussion Workshop (general public $120)

Add $15 to fee if registering after 4/10/04

Private Class (10:30 AM-12:30 PM)

Private Class (2:00-4:00 PM)

Private Class (4:00-6:00 PM)

Form of Payment: Cash (in person only @ The Arabic Bazaar)

Check (make checks payable to WMD Productions)

CC (please circle one) Visa MC Discover AMEX

CC number: ______

Expiration Date: ______

Name on Card:

CC Mailing Address:

Signature: ______

Please tell us how you heard about this Tour:

I ______agree to hold WMD Productions, Zein Al-Jundi, The Arabic Bazaar, Zein’s Dance Studio and all parties involved in the making of any of the event(s) associated with this Tour free of liability of any harm and injuries that may result from my participation in such event(s).

Signature ______Date ______

**please mail registration form and payment to**

WMD Productions . The Arabic Bazaar . Zein’s Dance Studio

5013 Duval ST. Austin TX 78751