Please register separately. An individual form is required for each participant.

Name:    ______________________________________________________

Address: ______________________________________________________

               ______________________________________________________

Phone:    ( ___ )  ____________________

                                                    **Required**

Email:      ______________________________________________________

Workshop $45.00/$55.00* per person …………. $ _____________

Show: # ______    Add. Tickets @ $10…………..$ _____________

Total Enclosed …………………………………………. $ _____________

​Disclaimer:
* No unauthorized video recording or flash photography of the workshop or show.
* Jo Hadley, Monica Walker, Crescent Moon Dance Company, Donna Carlton, and the University of Louisville assume no liability or responsibility for personal injury or for loss or damage of personal property.

 

Signature: _____________________________________________________

Make checks payable to and mail to:
Jody Hadley
2506 Wyeth Ct
Louisville, KY 40220


*Prices:
Workshop (includes class, lunch, and show)
$45 (Pre-registration needed by April 18th)
$55 (After April 18th and at the door)
Show
$10 each for non-workshop attendee
Workshop fees and show tickets are non-refundable unless the event is canceled.