Registration form :
Music and Dance Tour to Egypt 2004

Numbers are limited, so reserve your place now. Registration is easy :

If you would prefer, you may print this form, complete it, and mail it to Hala Dance with your check or money order


Registration form :
Music & Dance tour to Egypt 2004

**Full Name :
**Nationality:
**Departure City:
 
**Address :
**Telephone :
**Email :
 
Number of people  
Dancer(s) :
 
Musician(s) :
Instrument :
Amount
$ ($1750 per person)  
Cancellation Insurance
$ ($120 per person)

In case you have to cancel your trip after booking it due to an emergency

** Total Amount
$  
 
How did you hear about this event (check all that apply) :
Friend || Internet || Flyer or Printed Material || Other (please specify in comments below)
 
Special requirements or comments :
 
Please check you have filled in all the required fields (marked **) before clicking on the submit form button.