Contemplative Dance Workshops - Intro Registration Form

Register and Pay Online
Please complete the form below. Once you Submit your Registration Form, a link will be available to go directly to the payment page. Thank you!

Register and Pay by Mail
Print and mail the form below to Contemplative Dance, 24 O'Neil Road, Haydenville, MA 01039. Please make checks payable to Contemplative Dance. Thank you!

*First Name
Middle Initial
*Last Name
*Street
*City, State, Zip
*Email Address
*Phone
Cell Phone
*Affiliation/ Orgaization
*What workshop are you registering for?	Winter Retreat- 5th Annual! Three Nights (Thursday - Sunday), February 3 - 6, 2011, (Experienced), Westfield, MA Winter Retreat- 5th Annual! Two Nights, (Friday - Sunday), February 4 - 6, 2011, (Experienced), Westfield, MA Facilitators’ Workshop- 5th Annual!, May 6 - 8, 2011, Contemplative Dance / AuthenticMovement, (Experienced), Genesis, Westfield, MA
*How did you hear about the workshop?
*Please give us a few sentences about yourself.
*Required Fields If you wish to pay by mail, make checks payable to Contemplative Dance. Thanks!

Registration will not be complete until payment has been received.

For information contact:Contemplative Dance, 24 O'Neil Road, Haydenville, MA 01039
Phone: 413-268-3294 - Email: cdance-at-contemplativedance.org