CapitalDance.com

Registration Form - Hora Aviv 2003

Send the completed form by mail. For electronic registration see Note at the bottom.

Use the mouse or the TAB (forward) and shift-TAB (backward) key to navigate from field to field
Name First Last Gender Male Female
Street
City State Zipcode
Select Adult Non-dancing adult Child
Country Birthday Day
Telephone Home Work/Daytime
E-mail
Accommodation Desired Double Occupancy Single Occupancy
Sharing room with (if any)
( if blank, we will assign your room-mate)
Private Bathroom YES NO ( If blank, room with shared bath will be assigned.)
Age Group Below 30 30's & 40's 50 & plus
Special Meals Kosher Only (add $35) Vegetarian (If non selected, kosher style meals will be served)
About Children
(under 6 yrs old)		 Number of children attending:
Select: Meals required? Y N Beds required? Y N
More Information
Anything else we should know?


Print the form by your Browser (CNL+P)
OR

You may clear the entire form and start over at any time.

Please send the completed form with $50 deposit payable to
S. Batzri, 5 Grason Court., Rockville, MD 20850.

Note:
For electronic registration DO NOT use this form!
Instead, send email to mail at capitaldance.com,
with your name and the words NEED FORM in the subject.
We will forward the Registration Form that you can return by E-mail.

Return to Registration Information page

Return to Hora Aviv Home Page

Copyright by Capital Dance, 1998,1999,2000,2001,2002,2003