Worldwide Dance Adventures

Name

Email

Phone

City, State (where you're from)

I am registering as a (select all that apply):

Lead
Follow
I would be willing to change roles (as needed to help balance the class)
I am a Student (under 25yo with Student ID)

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-------------------- PLEASE CHECK THE APPROPRIATE BOX(ES) BELOW: --------------------

Please mark which Worldwide Dance Adventures you are interested in (mark all that apply).

Feb 19 - 26, 2023: "Waltz Week in Vienna"
April 26 - May 3, 2023: Chacala, Mexico "DANCE WEEK" [SOLD OUT]
June 9-18, 2023: "NW Dance Fest" + Alaska Dance Cruise
Oct 24 - Nov 3, 2023: San Miguel de Allende, Mexico "DAY-OF-THE-DEAD"
TBA: Danube "Bike, Barge, & Dance Cruise" + Oktoberfest Lindy Exchange (Munich, Germany), (Sept 2023)
TBA: Valencia, Spain - Swing Week & Balboa Festival (May, 2023)
TBA: New Orleans "French Qtr Festival" Weekend + Caribbean Dance Cruise (April , 2024)
TBA: Costa Rica Dance Adventure (details pending)

Please list your diet preference (if you selected "Other", please elaborate in the "anything to add" field below. Please also let us know any food allergies you might have)

Regular Diet
Vegetarian Diet
Gluten-Free Diet
Dairy-Free Diet
Other (please elaborate below in the "Anything to Add" field)

How are you registering?

I am signing up with a partner/traveling companion and we plan to share a room
I'm signing up as a solo participant and would like a SOLO ROOM
I'm signing up as a solo participant and would like to find a roommate to SHARE A ROOM with

If you are planning to register with a partner, please let us know who that is:

If you are signing up as a solo participant and looking for a roomate, who would you be willing to share a room with?

MALE roommate only
FEMALE roommate only
Either MALE or FEMALE

Anything to Add (health concerns, food allergies, dietary restrictions, etc):

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======================== PAYMENT ========================

Payment can be made using your credit card or PayPal account from our payment page (Click on "PAYMENT" in the menu on the left), by Venmo (see option below), or by personal check or money order sent by mail. Please check the appropriate box below to indicate your intention for payment. Payment by Venmo or check will help you to avoid the added online PayPal charge.

Please mark the appropriate box below:

I am paying by PayPal or credit card online (Please be sure to use the "Friends & Family" feature for payment, otherwise we will need to add a 4% surcharge).
I am paying by Venmo using @Ari-Levitt-1. (The picture is of Ari carrying a dance partner. The last four digits of Ari's phone are 9172).
I am paying by check or money order (made out to "Roll Up The Rug") and will need a mailing address to send this to

If you are paying for someone else, or if they are paying for you, please let us know that here:

Any special needs or requests?

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If you are having trouble reading the Captcha words below, try clicking the reset button (the symbol with the two circular arrows) until you find a pair of words that you can read. If you're still having trouble, go to the "Contact Us" page and read the "Registration Trouble-Shooting" section at the bottom of that page.