ALHAMBRA NIGHT 2017 - REGISTRATION FORM
Saturday, July 15, 2017
(Please type your information and print)
Send to: Conchi Madson, 3749 Davenant Avenue, Cincinnati, Ohio 45213
Name:_________________________________________ Dance Name______________________________
Address________________________________________ City:________________ Zip Code____________
Phone__________________________ E-Mail Address___________________________________________
Fee to perform at the show $15.00 per person # $_______
(attendace to show free)
Evening show - Adults $18.00 # $_______
Children under 12 $10.00 # $_______
Under 5 years - Free
Concert Video by Tony: $35.00 shipping included # $_______
Please Note: No refunds unless event is canceled!
Send Check to: Conchi Madson, 3749 Davenant Avenue, Cincinnati, Ohio 45213
Conchi and Mayerson JCC cannot assume any liability or responsibility for loss of property or injuries incurred by you or others while you are exhibiting, entertaining, performing or otherwise participating in this event. By agreeing to participate, you assume the risk and responsibility for injuries.