Please complete this form online, then print
and mail it with payment to: Luna Kids Dance, 2138 Cedar Street, Berkeley, CA 94709
You can also contact Alisa Rasera to register for any workshop. Email: arasera@lunakidsdance.org First Name:
Last Name:
Street Address:
City:
State:
Zip:
Phone:
E-mail:
How did you hear about us?
Workshop Title:
Fee: $
Date:
Workshop Title:
Fee: $
Date:
Workshop Title:
Fee: $
Date:
Total Fee
$
Applicable Discounts**
$
Annual Registration Fee
$ 10.00
Total Owed
$
Fees:
Workshop fees differ.
Please consult the Workshop Schedule for
specific workshop fees. **Discounts:
15% for NDEO/CDEA members
5% if registering for 2 workshops
10% if registering for 3 workshops
(must pay in full for multiple workshops to receive discount)
50% discount for full-time enrolled students
(no other discounts apply, student ID required)
Enclosed
is (check one):
$50 non-refundable deposit
my full payment of $
(I understand $50 of this is non-refundable) Balance Due .............(full
balance due one week prior).................................(if
applicable)$
