DFH CLASS REGISTRATION

Simply Print these next few pages and mail or fax them in right away!!
It is our desire and God's design that we accommodate and bless you appropriately, promptly and with a spirit of excellence. Therefore, to assure that administration details also are done decently and in order, please have your registrations in (or at least post marked ) two weeks before your arrival. Any registrations sent in, brought in, or post marked AFTER that date, will need to send or bring an additional $15.00 to cover the extra administrative costs. Thank you for your early consideration. It is greatly appreciated. 

REGISTER NOW! 
Title:______________________________________________________________

Name: ____________________________________________________________

Address:___________________________________________________________

City/State:_________________________________________________________

Province/Country: ___________________________________________________

Zip Code: _______________________________________________

Phone #: __________________________________________________________
(include country code if foreign)

E-Mail Address: _____________________________________________________

Name of  Church You Attend: _____________________________________

Please have individual registration forms for each person.

At this time, because we are in a rental facility, we are only allowed to have students 13 years and older. However, each one, under age 18 must be accompanied by a registered, participating, responsible adult, who has authority to sign their waiver form.


Enclosed please find:
Please mark or write in the appropriate space(s)
Monthly Fee
$920.00
X How Many Months?
 
=
$
Weekly Fee
$265.00
X How Many Weeks?
 
=
$
Daily Fee
$55.00
X How Many Days?
 
=
$
Text Book Fee (Required) - Includes 8 Books
 
=
$99.00
Additional Love Gift
 
=
$
TOTAL ENCLOSED
 
=
$
Thank-you, and may the blessings of God over take you!!!

Method of Payment - Please Circle One

MC            VISA            AMERICAN EXPRESS            DISCOVER            CHECK            MO 

EXPIRATION DATE:_________________________  CSC #__________________________

_ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _

SIGNATURE:_______________________________________________________________

Please make checks payable and mail to:
Dancing For Him
13 Cole St.
Kingston, MA 02364

Or fax form (with credit card info) to: (781)585-5722
 
IMPORTANT: PLEASE BE SURE YOU'VE CONFIRMED ALL THE DATES FOR YOUR STAY (WITH DFH), BEFORE SENDING IN YOUR REGISTRATION.
lynnmhayden@mac.com or (781)585-2512

 
The amount of registrations, products, offerings, support, etc., is non-refundable. If for some unforeseen reason you will be unable to attend, please consider your tax-deductible donation a love gift or scholarship to further the work of God through Dancing For Him Ministries. Thank-you for your generosity.
 

PLEASE FILL IN, SIGN, AND MAIL IN
WITH YOUR REGISTRATION
Thank You.

WAIVER OF LIABILITY (ADULT-18YRS. OR OLDER)

PRINT NAME: __________________________________________________________________________________

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 Training Classes —Date(s) of Program: _____________________________________

WAIVER OF LIABILITY - CHILD (UNDER 18 YRS.)

PRINT CHILD’S NAME:___________________________________________________________________________

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., Tom Hayden, 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 Training Classes - Date(s) of Program: ___________________________________

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):______________________________________________________________ 

DATE: _________________________
 

CONTACT INFORMATION

Dashan or Lynn:

13 Cole St.
Kingston, MA  02364
Phone: 1(800)787-1623
Fax:   (781)585-5722


E-mail:lynnmhayden@mac.com
 
 
Be sure to see our ON LINE BOOKSTORE!!! You may order your text books in advance, if you like, by going to the book store and ordering all 8 books for a quantity discount.

Also on this page:

CONTACT INFORMATION

Dancing For Him
13 Cole St.
Kingston, MA 02364
Phone: (781)585-2512
Fax: (781)585-5722