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LowCountry Line Dance Fest, January 25-27, 2008

Please complete the entire form below and you will be receiving a confirmation e-mail very soon after. Your Registration Package will be waiting for you when you arrive at the event.

(please fill out a separate registration form for each person)
E-mail: (required)
Name: (required)
Street Address:
Any Additional Address Information:
City:
State/Prov:
 Zip/Postal:
 Home Phone:
Business Phone:
 Mobile Phone:
 Fax Number:
Verify E-mail:
Event Title:

LowCountry Available Event Passes

(you must choose one of the selections below)

Weekend Event Pass $75.00
(Includes all workshops and evening dances.)
Senior Weekend Event Pass (Age 62+) $65.00
(Includes all workshops and evening dances.)
JR Weekend Event Pass (Age 16 & under) $55.00
(Includes all workshops and evening dances.)
Friday Only Pass $45.00
(Includes workshops and evening dances on FRIDAY ONLY.)
Saturday Only Pass $55.00
(Includes all workshops and evening dances on SATURDAY ONLY.)
Spectator Pass (All Weekend) $35.00
 
Friday AND Saturday Evening Dances $25.00
(Includes dancing for BOTH NIGHTS.)
Video Camera Pass $40.00
 

Optional Items Available For Purchase
(please select yes or no for the items below)
Step Description Booklet Yes $25   No
DVD Yes $50   No

NO REFUNDS ~ NO REFUNDS ~ NO REFUNDS

* * VERY IMPORTANT: You may pay for more than one person, or someone may pay for you. However each person attending must fill out a separate registration form. If you answered 'YES' to one of the 2 questions below, please enter the names in the box below so that Carolyn & Rick know who belongs together. If you answered 'NO' to both questions then go right to the Disclaimer part!


* If you are paying for someone, please answer 'YES' to the first question and 'NO' to the second question. Please enter that person's name in the box below. Please fill in the Disclaimer box, and then complete the payment section!


* If someone is paying for you, please answer 'NO' to the first question and 'YES' to the second question. Please enter that person's name in the box below. Please fill in the Disclaimer box, and you can skip the payment section!

Are you paying for more than one person?   Yes   No
Is someone paying for you?   Yes   No
Please list their names:
(Each person MUST fill out a separate registration form)

* * VERY IMPORTANT: You must read & agree to this Disclaimer to register:  “I agree to hold the organizers of this event and their agents harmless from all suits, claims or demands of every kind and character arising out of and in conjunction with this event. I hereby authorize the reproduction, sale, copyright, exhibition, broadcast, and/or distribution of any videotape without limitations. I understand the physical risks of entering social dancing and assume full responsibility for any injury or personal damages resulting from the event named above. I certify that I am/are 18 years of age or older (applicable to Legal Guardian if under 18 years of age)” The state of South Carolina policy prohibits alcohol in public areas (workshops & evening dances). I understand and agree to purchase alcoholic beverages at the hotel bar in order to bring them into the evening dances.

Do you agree to the terms of the disclaimer?  
You must type in Yes I Agree in the box above for the form to process!

Check Payment Method
Check Number:  Total Amount: 

If you are choosing to pay by check, after you complete this form, we ask that you please make out and mail your check to: Love2Dance, Inc., 729 Dove Haven Lane, Myrtle Beach, SC 29579

Credit Card Payment Method
(if you're using a credit card please choose from below)
Check     Master Card     Visa     Discover     Telephone

You may also pay with a Credit Card by telephone - (843) 607-5048. Just fill out the online form but leave the credit card information empty. Then give Carolyn & Rick Robinson a call and give them your credit card information over the telephone. Please select 'Telephone' as your choice above and call Carolyn & Rick ASAP

Bank Card Type:  Credit     Debit
Card Number:
 Exp. Month:
 Year:
Exact Name on Card:
 SVC #:
Total Amount On Card: 

Please be sure that the mailing address you entered above is the actual correct mailing address for the bank card you are using! The address needs to be correct in order for the card transaction to process!


The e-mail that is created and sent by this form goes to E-mails Servers that are H.I.P.A. (Health Information Protection Act) compliant. H.I.P.A. requirements insist that there be a 128 bit encryption in all e-mails coming and going from the servers.


    

* * Important Note:
Clicking on the 'Submit to Love 2 Dance' button will send an e-mail to Love 2 Dance at this address: . Then you will be taken to a 'Online Confirmation' page. If none of this occurs then the information was not sent to Love 2 Dance. At this point you can either try to submit the form again or please contact Rick & Carolyn Robinson directly either by using this e-mail address:  or pick up the the phone and call them: (843) 607-5048


 

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