TOUR REGISTRATION FORM (SK2005)
Name _______________________________________ O M O F
Name as you wish it to appear on badge _________________________
Prefered Departure City _______________________
Smoking? yes O no O
Special Diet? _________________________________
Total enclosed: $ __________ Balance due: $ ____________
Please note: If you are registering as a single, you will be assigned a double room with another single of the same sex. Single supplement is also available if you prefer private accommodations for an additional charge of $375
If you prefer a roommate Please give name. _________________________________________________
Do you want your name and telephone number appear on tour roster? Yes O No O
Make check or money order in U.S. dollars payable to: Middle Eastern Music and Dance,
and Mail To: Middle Eastern Music and Dance, 3244 Overland Ave., No. 1, Los Angeles, CA 90034.
PHOTO RELEASE STATEMENT: By registering to go on this tour, each attendee grants Middle Eastern Music and Dance productions, its employees, agents and assigns; the use of attendee's likeness, voice, sound effects and/or musical performance in photographs, motion pictures, videotapes, and recording media. Each attendee also grants in perpetuity the right to reproduce and/or redistribute in any manner whatsoever the attendees likeness, voice, sound effects and/or musical performance.