London ON RSCDS Workshop, 25 February 2006 Registration Form Please fill out & print one form for each person attending Preferred Salutation Ms.   Mr.   Dr. First Name   MI   Last Name Address1 Address2  City     Prov./State * Postal Code Country Phone   Ext.  Email  * Weekend Activity Options * $5 - Ceilidh $20 - Classes Only $30 - Classes & Supper $30 - Supper & Evening Dance $50 - Full Weekend (includes Friday Ceilidgh) N.B. No fees will be refunded unless canecellation is received by Feb. 15, 2005 Dancing Level * Less Experienced        More Experienced Special Requests I understand that participation in Scottish Country Dancing demands a reasonable level of physical fitness, and that if I undertake any activity beyond my personal capability, I will not hold the London Branch of the Royal Scottish Country Dance Society responsible for any resulting injuries. Please print & mail in with your cheque - to: RSCDS London Canada Branch PO Box 46034 956 Dundas St. London, ON N5W 6B2 Hospitality: contact Nancy Duncan, 519-451-7894 Hotel Accomodation: London Executive Suites, 800.265.5955 362 Dundas St. (near Colborne) Other information: Joe Craigen 519.455.1025 craigan1025@rogers.com  or Marel Fielding 519-471-3229  mefielding@sympatico.ca