Workshop Registration Form
12th Annual Wiggles of the West
July 13-15, 2007
at Boomtown Hotel & Casino
Workshop Information
Name __________________________________________________________________
Dance Name ____________________________________________________________
Address _________________________________________________________________
City ___________________________ State __________________ Zip Code _________
Day Phone ______________________
Evening Phone ___________________________
Fax ______________________
Email ________________________________________
Workshop prices do not include tickets to the contest,
Those are paid separately
Thursday July 12
(____) 10 am - Noon ... "Beading for Belly Dance” taught by Janie of Designs by Janie ...
$25.00
(____) 1 pm - 3 pm ... "Evolution” taught by Halima, Coach to the Stars ... $25.00
(____) 3:30 - 5:30 pm ... "Learn to Fly" taught by Mezdulene, editor of Jareeda ... $25.00
Friday July 13
(____) 2:30 pm - 4:30 pm ... “SharQui™ & Drum Solo” taught by Oreet, 2006 Entertainer of the Year ... $25.00
Saturday July 14
(____) 9 am - 10 am ...“Hands, Arms, and Head Frames " taught by Aneena, Past Entertainer of the Year & Headliner of the Year ... $15.00
I hereby release Two Old Bags, Ltd., Boomtown, and all their representatives from any and all liability for loss or injury incurred in association with those workshops and the Wiggles of the West Contest.
Signature _________________________________________________________
Tickets to Contest
___ Daily tickets $10.00 each
___ 3-day Pass $25.00 each
___ Senior (65 & over) or Children (under 12) daily $8.00 each
___ Senior (65 & over) or Children 3-day pass $20.00 each
Pay with PayPal
February 3, 2007