Rhythm Tap Form

Print this form and mail with payment to:

Heather Cornell's NYC Rhythm Tap Intensive Workshop
P.O. Box 571
Valley Cottage, NY 10989

Heather Cornell's 2010 Rhythm Tap Intensive Workshop

Name _________________________________________

Address ________________________________________

City/State/Zip ___________________________________

Country ________________ Phone __________________

Email ___________________________________________
Don't forget to give a number where you can be reached after July 1st)

I enclose:

Grand Slam - all classes - $750

*Please pay in US Dollars. International money orders accepted.

*Please make checks payable to Heather Cornell.

*20 student limit. No refunds. No discounts.