Pay through Paypal or mail in the registration form with a check. Please scroll down for form

PLEASE Scroll down and: FILL IN THE REGISTRATION FORM BELOW THE PAYMENT BUTTONS!!! Please read REFUND policy.
Early Belly Rate deadline: June 30
Regular registration deadline: August 15th
Late registration: After august 15th

Dancers (includes all workshops)

Early Belly $205 Regular Registration $235 Late Registration $275

Dancers (3 days only)

Early Belly $175 Regular Registration $205 Late Registration $245

Daughters

Early Belly $100 Regular Registration $120 Late Registration $150

Non-Dancers (No workshops)

Early Belly $140 Regular Registration $165 Late Registration $195

Vendors $50 Fee in addition to the regular fee

Register below

REFUND POLICY
Retreat packages are non-refundable after purchase. If you cannot attend, you may sell, transfer, or gift your space to someone else. Please let us know if you are unable to participate and who will be taking your place so we can keep our registration roster up to date. Thank you!

By completing my purchase, I understand and agree to the refund policy. I hereby release Mezdulene Reed/Bliss, Camp Myrtlewood, and all staff, instructors, and vendors associated with Mezdulene’s Belly Dance Retreat for any injuries or damage that may occur while I am attending Mezdulene’s Belly Dance Retreat.

Online registration:

Name

First Name

Last Name

Email Address

Phone number

Share cabin with:

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mail in registration:

NAME(S)________________________________

DANCE NAME______________________________

E-MAIL ADDRESS__________________________________________________

ADDRESS____________________________________

CITY/STATE/ZIP_________________________

PHONE_______________________________

YOUNG CHILD__ROWDY CABIN__QUIET CABIN__

I WANT TO BE IN CABIN WITH:_________________________________________________________

COST: Until June 30 Until August 15 After August 15

____Dancers (includes workshops).....$205.00...........$235.00…………$275.00

____Dancers (3 days only).……….....$175.00...........$205.00…………$245.00

____Daughters and Granddaughters...$100.00….......$120.00……….$150.00

____Non-dancers (no workshops).…..$140.00..…….$165.00……….$195.00

____Vending Space...................................................$50.00 plus regular fee

I am enclosing: $____________No Refunds (see Refund Policy)

Credit Cards Now Accepted

Credit Card Number ________________________________________

Expiration ______________

Three digits on back of card__________ Billing Zip Code________________

You may also pay through paypal to mezdulene@mezdulene.com

Please remit to Mezdulene, P.O. Box 3145, Coos Bay, OR 97420. Questions? Call (541)-315-5550.