Spring Fling Workshop With Derek Steele

Spring Fling Workshop With
Derek Steele
Saturday, April 18th, 2015
Backroads Saloon
15325 W. Michigan Ave, Marshall, MI 49068
One day workshop including evening lessons and admission to club that night.
Registration 10 am, Lessons 11 am-5 pm. Lunch break from 1:00 - 1:30 with pizza, salad bar and drink
$35 for entire workshop including lunch and admission to club that night
Derek will be joined by Lia Reau and Pete and Jen Zappulla
Address:_______________________________________________ State:_______________ Zip:_______________
Phone:____________________________ Email:___________________________________
Dance level: Beginner Intermediate
I, the undersigned, for myself, heirs, executors, and administrators, hereby waive, fully release and agree to hold harmless the organizers of the event, employees, staff members and agents
from any and all lawsuits, claims or demands arising from and in connection with this event, whether as a spectator, attendee or staff member. I understand the physical risks of social
dancing and assume full responsibility for any injury or personal damages resulting from my participation in this event. I hereby authorize the reproduction, sale, copyright, exhibition,
broadcast and/or distribution of any videotape and photographs taken of me during the activities associated with the event, without limitations. I certify that I am 18 years or older (applies
to Legal Guardian if under 18 years of age). I understand and fully acknowledge that NO REFUNDS will be issued.
Signature:_______________________________ Date:______________________
Make Checks Payable to: Backroads Saloon
Mail Registrations to: Derek Steele
6099 Lakeshore Rd
Burtchville, MI 48059
For additional information contact Derek-586-360-6792. [email protected]
Hotel info: Arbor Inn Located right next door to Backroads Saloon
Room rate-49.99 +tax. Phone (269) 781-7772