Registration Form for
Master Workshop with Samara
June 13 - 17, 2008

Name_______________________________________________________

Address_____________________________________________________

City_________________________ State______________ Zip__________

Telephone: Day_____________________ Evening___________________

E-mail_______________________________________________________

Stage name_________________
I will perform at the gala? Yes _____ No _____ (Live band or CDs only)

Event	Fee Schedule	Number	Total
Fri - Tues., June 13 -17 Master workshop	$450.00 ($400.00 before May 15, 2008)
Sunday, June 15 Gala for Workshop Participants	SHOW: $10.00. Payable in advance by check or cash to Teri Adell. Cash only at the door. DINNER: $15.00 per person minimum, plus tax and 18% gratuity, payable to Lafayette Grill at the Gala.
Sunday, June 15 Gala for Non-workshop Participants	SHOW: $20.00 in advance. Payable in advance by check or cash to Teri Adell. $25.00 cash only at the door. DINNER: $15.00 per person minimum, plus tax and 18% gratuity, payable to Lafayette Grill at the Gala.
	Payment in US funds by check or cash only. Absolutely no refunds unless event is cancelled.	TOTAL ENCLOSED

Make checks payable to: Teri Adell                                                 212-582-6149
        435 W. 57th St.                                                                        samaradance@ecoisp.com
        Apt. #1-H                                                                                 www.SamaraDance.com
        New York, NY 10019

Workshop ONLY is also payable by credit card. Register online at www.AlvinAiley.org or call 212-405-9500
Gala reservation to Terri Adell ONLY by cash or check per above.

You will receive a complete schedule of events and class times at the workshop registration and sign-in on Friday, June 13, 2008. 10:00 AM check-in at Alvin Ailey Studios, 405 W. 55th Street, New York, NY.