DANCEFEST NEW JERSEY-2003
Mail-In Registration

Print & Mail to:

Marisa Pierson
2 Maryland Drive
Jackson, NJ 08527

Tel. 732-905-0059

Classes registering for (check all that apply)

________Su'ad ( Arms & Hands)
________Farasha (Zeffa)
________Aviva! (Breath & Transition)

_______Total Class Fee

_______Performer Package: 3 classes & Showcase ($55-prepaid only)

_______Video of Your Dance ($10)

Dancefest NJ Showcase Tickets (indicate number)

_____Workshop Attendee Tickets ($10)
_____Family & Friends tickets ($15)

_____Total Ticket Fee

_____Grand Total for Classes and Show

*Please make checks payable to: Marisa Pierson

Name:________________________________________________________________

Address: ____________________________________________________________

City, State, Zip:_________________________________________

Phone: ____________________________

E-mail:_____________________________

Do you wish to perform? Yes____ No_____.

Dance Name/ Name of Troupe: (list all performers-use separate sheet if needed) _____________________________________________________________
_____________________________________________________________
_____________________________________________________________

Style: (Oriental, Folkoric, Tribal, etc.):______________________________________

Length of Dance: (up to 6 min.) _______________________