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A Scottish Country Dance Weekend June 23-25, 2017
At The Academy of the Holy Cross, Kensington, MD

Registration Form

This form may be printed and mailed with your check.

Name(s):
Address:
City, State, Zip:
Phone:
Email:
	Number attending	Intermediate & Advanced	Basic*	Total Cost
Welcome Dance		$25	$15	$
Saturday Class		$20	$15	$
Ball Review		Free
A Capital Ball		$30	$15	$
Package**		$70	$40	$
Check here if you need a scholarship ___ (see web site for more info.)
	TOTAL ENCLOSED			$

  * Basic: Students and Beginning Dancers with <6 months Scottish Dance experience
** Package - payment must be received before 6/7/17

Please make checks payable to A Capital Weekend and mail with Registration form to:
A Capital Weekend
Sally Beth Buckner
4521 Everett Street, Kensington, MD 20895