Please print these 3 forms and fax or mail them to the information below. Not necessary if registering on line. They must be postmarked and/or received on or before June 1, 2018 (for the extra early savings date) OR postmarked and/or received on or before August 2, 2018 (for the early rate). OR postmarked and/or received on or before October 2, 2018 (for the regular rate). Anything postmarked, faxed, mailed, received after October 2, 2018, must pay the "at the door rate" (see info page). Thank you. Absolutely NO more registrations will be received after October 23rd. No at the door registrations.
To save on space, paper and to be able to read it more clearly, if you'd like, you may copy and paste all the information into a Word document, type in what's needed and then print that out to send in.
Phone #: ___________
E-mail (please print very clearly):
**Having EVERYONE'S email is very important. As the full registrations come in, I will be sending along several letters to keep you informed and about what to expect. Also, for those interested, you may communicate with one another about room/ride sharing, etc. This has been a wonderful way to get to know one another and to help one another with expenses. Thank you for printing clearly! We do not need the email addresses of anyone under 18. Please indicate age below. Thank you.
If you need more room to write, please feel free to write elsewhere on this sheet.
Age (if under 18) ______________________________
Please note: This conference is for adults only (ages 16 and up)
Enclosed please find (please check mark all that apply):
_____$289.00 - Individual - Received on or before June 1, 2018 Extra, Extra Early Savings Date
_____$318.00 - Individual - Received on or before August 2, 2018 - Early Savings Date
_____$333.00 - Individual - Received on or before October 2, 2018 - Regular Savings Date
_____$348.00 - Individual - Received on or before October 23, 2018 - At the door rate. This must be received on or before this date.
No registrations received after this date.
________ Additional Love gift (helps offset conference expenses)
________ Total. Thank-you, and may the blessings of God over take you!!!
PAYMENT METHOD - Please Circle One
MC VISA AMEX DISCOVER CHECK MO (US FUNDS ONLY)
CC# _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _
(CSC# for AMEX/DISC only)_____________
Please make checks or money orders payable and mail to:
You may mail in your payment US FUNDS ONLY (check, MO, or Credit Card information) along with the registration, waiver and concert forms. However, we strongly encourage you to please register on line. It is much easier and you do not need to send in any forms. It is a secure site as well.
Pastor Lynn does not want to display her personal address on the internet and we are trying to be good stewards of God's money by shutting down the PO box that hardly ever gets used. Therefore, if you absolutely must mail, please email: email@example.com or call to get an address: 863-398-8161 Thank you for your cooperation and understanding.
Or call with credit card info: 863-398-8161
The amount of registrations, offerings, support, etc., is non-refundable, nor is it transferable to another conference. If for some unforeseen reason you will be unable to attend, your tax-deductible donation will be considered a love gift or scholarship to further the work of God through Dancing For Him Ministries. Thank-you for your generosity. NO one-day rates available. We encourage you to attend the entire conference or as much of the conference as you are able.
Please fill in, sign and mail in with your registration.
OR if registering here on line, simply agree with your electronic signature in the box at the bottom of the conference information page. When registering a group and putting a yes in the waiver drop down, that means that everyone in your group has read and agreed.
In consideration of participation in this dance program and instruction, I the undersigned intending to be legally bound, here by for myself and anyone acting on my behalf, release any and all claims for damages I may have against Dancing For Him Ministries, Inc., Lynn Hayden and their sponsors, representatives, successors, and assigns for any and all injuries or death suffered by me in this program. I attest and verify that I know participation in this event can be a potentially hazardous activity. However, I have sufficiently prepared for this event and know that I am participating at my own risk. The waiver extends for the duration of the program. I also release DFH use of any video footage of me. I have read and understand this waiver of liability, and agree to the same.
YOUR SIGNATURE: _______________________DATE: ____________
Program: Worship Dance Workshop Date(s) of Program: November 2-4, 2018
PRINT CHILD'S NAME:_____________________________________
OR if registering on line, simply put 'yes' in the child waiver agreement drop down list, at the bottom of the conference information page, then put their name in the comments box after the credit card information, upon check out.
In consideration of participation in this dance program and instruction, I the undersigned intending to be legally bound, hereby for myself and anyone acting on my behalf, release any and all claims for damages I may have against Dancing For Him Ministries, Inc., Lynn Hayden and their sponsors, representatives, successors, and assigns for any and all injuries or death suffered by me in this program. I attest and verify that I know participating in this event can be a potentially hazardous activity. However, I have sufficiently prepared for this event and know that I am participating at my own risk. The waiver extends for the duration of the program. I also release DFH use of any video footage of me. I have read and understood this waiver of liability, and agree to the same.
SIGNATURE (Child): ________________________________ DATE: __________
Program: Worship Dance Workshop - Date(s) of Program: November 2-4, 2018
I am the parent and/or guardian of the aforementioned child. I consent to the waiver of liability on behalf of the child. I have read and understood this waiver of liability, and agree to the entire document intending to be legally bound thereby.
SIGNATURE (PARENT/GUARDIAN): ____________________________________
PRINT NAME (PARENT/GUARDIAN):_____________________
Are you and/or your group participating in the Saturday evening concert? YES/NO
If yes, please continue and fill out this form. Mail or fax it in with your registration/payment/waiver. Please remember it is first come, first served . Only the first 12 dances that are fully registered will be able to participate. Once it is full, a notice will be posted here, just under the CONCERT REGISTRATION FORM heading.
OR Just fill in the appropriate information in the comments box after entering your credit card information, upon check out.
Individual Name ____________________
Name of Team Presenting: _______________________
Number of people in dance: ___________________
Name of Song to which you'll be dancing:____________________
Name of Artist: ___________________________
Length of Song: _____________________(please, under 6 minutes)
Type of dance (worship, praise, hip/hop, mime, etc.): __________________