Booking Mirror Image Bellydancing Twins

Booking Form

Fill out this form to book your event and/or to receive more information.
Click here for a printable form.

Please note that I've had problems getting this form to work for Mac users. Please phone or email me if you haven't got a response or if you have difficulty with the form. If you have any suggestions to make the form work better for Macs, please let me know!!

Contact Person (whom should we call?): How can we contact you (phone # or email address):
Date (date you want to book): Time:
Referred by (how did you find out about us?):
# of people who will be there (approximate):
Bellygram (1 song) Short Show (2 songs) Show (3-4 songs) Show w/mini-lesson (3 songs + 15 min lesson - great for stagettes) Group class (1 hr lesson - a fun "chick's night" idea!) (for longer shows or further information, please contact us at the numbers above or use the Special Requests/Comments area below)
Mirror Image (duet w/Lisa & Lara) OR Lisa OR Lara
Event (what type of event is it): Type further info here.
Location (where is the event): Are the facilities available for prior viewing: No Yes, anytime Yes, w/appt
Special Requests/Comments:	Type requests/comments here.

Mirror Image Bellydancing Twins Courtenay: 250-336-8526 / Nanaimo: 250-751-3603 bellydancers@shaw.ca

Don't forget to sign the guestbook!

(c) 2006 Lara Wadelius Kirkpatrick & Mirror Image Bellydancing Twins
Page last updated: 09-Oct-2006