Jareeda Magazine - Retreat Reg Form

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21st Annual Belly Dance Retreat

You can now register and pay for the retreat online! Please fill out the following form and click submit. You will then be redirected to a payment page, where you can pay with your credit card through PayPal.

If you do not wish to pay online, please click here, print, fill out the form and mail it to the address provided.

Name:
Dance Name:
Email Address:
Address:
City:
State:		Zip:
Phone:
I want to be with:
Please note if you have a young child, want a rowdy cabin or a quiet cabin, etc.

Click send to send your registration. You will then be directed to the payment page to make your payment via PayPal.

Events Sponsored by Jareeda
--2009 Belly Dancer USA Contest and International Bazaar
--Mezdulene's 20th Annual Belly Dance Retreat
--Tribal Oasis Bellydance Festival and Evening Show

SUBSCRIPTIONS: U.S.A. $31; Canada $37 a year; other countries $47. Make checks payable to: JAREEDA and send to P.O. Box 680, Sutherlin, OR 97479. Visa and MasterCard also accepted; for information: e-mail jareeda@jareeda.com