REGISTRATION FORM
Tango Workshops with
Rodrigo Palacios and
Agustina Bereinstein, 14-15 August
2010
Personal Details
Name:................................. Phone 1:
.......................
Surname:............................. Phone 2:...........................................
Leader/Follower:
Email:............................................
Country:............................................
Level:
-
Level (Intermediate/Advanced):
.....
-
Dancing experience (months/years):
Partner for tango classes:
-Name
of Partner
-Please
find partner for me □
Classes/Milonga (please choose classes):
□ Package A 2 tango classes: a,
b, c, d, e
□ Package B 3
tango classes: a, b, c, d, e
□
Package C 5 tango classes
□
Corazoneando- milonga & show
□
Early Bird Package (register before 15 July)
a) Cash payment
b) Payment made to our
bank account (please email us at tangofever_ireland@yahoo.com to get bank details -IBAN
and SWIFT code)
Total amount paid:
*********** Please enclose proof of payment ************
Signed Date