Taste of New York

Please use only English Letters. All fields must be filled up

First Name:

Last Name:

Gender:

Male Female

Date of Birth(day/month/year):

Age:

City:

State (USA & CA):

Country:

Email Address:

Home Phone:

Cell Phone:

Contact Person in case of Emergency:

Relationship to applicant:

Contact Person's Phone number:

Do you have medical insurance for Europe?

Yes No

Any disability/medication?

Yes No

If yes, please specify:

Dancing Experience:

Presently training at:

Where did you hear about the workshop?

Remarks (If you will come with a chaperon, please let us know here):

Cyprus Residents & Nationals:

2-week intensive registered before April 30th:	Euros 300
2-week intensive registered after May 1st:	Euros 400
2-week intensive & Hip Hop Workshop	Euros 300+200
Only Hip Hop Workshop	Euros 300

Non Cypriot Students:

2-week intensive registered before April 30th:	Euros 800
2-week intensive â€“ registered after May 1st:	Euros 900
2-week intensive & Hip Hop Workshop	Euros 800+300
Only Hip Hop Workshop	Euros 500

DVD of Show:	Euros 25


Total:

By submitting this form I agree to pay the registration / Processing fee of Euros upon registration in order to secure my place. The balance is to be paid upon arrival.
- Online payments by credit card will be charged 3.5%.
- By submitting this form I agree to all terms and conditions specified below.

I will pay the registration fee by: Credit Card On Line or Bank Transfer
You will receive an email confirmation on how to proceed with the payment. (How do we do this?)

TERMS AND CONDITIONS
- Registration fees (200 Euro) should be paid at the time of registration
- Registration fee refundable if cancelled before June 15,2010.
- Choreftika Vimata has the right to use any photos/videos taken during the workshop for internal use (advertising for future workshops). If you do not agree to this term please inform us before arrival, and we will respect your wish.
- Choreftika Vimata reserves the right to refuse any students who misbehave, or do not fit the general level of the workshop.
- All participants must have a personal medical insurance coverage. We can provide this upon arrival for 40 euros extra.
- Parents / Family are welcome to join, please contact us for more information.
- Breakfast only is included in your room reservations. If you eat any additional meals at the hotel you must pay.
- Choreftika Vimata reserves the right to change class schedule as necessary.
- If one of the teachers is unable to make it to the workshop, we will provide another teacher of the same caliber to take his/her place.

I have read the terms and conditions and I agree with them.

Pay only Registration Fees (200 Euro)

Pay Full Amount