2009 Ready to Dance Booking Form

Dancer:

Name:
Age:
Address:
Email:
Phone
Mobile:
Home:
Work:

Parent/Guardian:

Name:
Email:
Contact Phone Number:

Notes:

Please note any medical issues, allergies or injuries we should be aware of:

Days Attending:

Cost:

$350 for full course ($100 deposit - non refundable)
$280 each for siblings
$100 per individual day (if not attending full course)
Deposit required by 15th of December, full payment required by 15th of January 2010, and no refunds are given after the 15th of January.
Cheques should be made out to Westmere Pilates Ltd.

Payment:

Westmere Pilates Account Number: 12-3019-0640271-00 Use your last name and "RTD" as a reference
Amount Paid Online:
Amount Posted:

Westmere Pilates
152 Garnet Road
Westmere
Auckland
New Zealand

Tel: +64 9 3781612
Email: info@westmerepilates.co.nz