Register - BC BellyFest

BC BellyFest Registration Form Checklist
Please make sure to fill in and send the following documents in order to have your registration
processed:
1. Conference Registration Form (2 pages)
2. Payment Form ( 1 page)
3. Waiver (2 pages)
Registration forms can be emailed to: [email protected]
Cheques can be mailed to Get Bent Studio #115-1475 Fairview Road, Penticton, BC. V2A 7W5
OR payments by Credit Card can be made by phone at Get Bent Studio: 250-462-1025
Come and celebrate the art of belly dance at BC BellyFest 2015!
BC BellyFest
115 1475 Fairview Road
Penticton, BC V2A 7W5
250.462.1025
www.BCBellyFest.com
Connect - Educate - Inspire
Conference Registration Form
Name_________________________________________________
Phone_________________________Email________________________________________
Mailing
Address____________________________________________________________________
Class Selection
Please select the conference classes you wish to attend
Saturday April 25
Business From the
Hip
Alice Bracegirdle
8:15-9:30 am
Costuming for
ATS
Tonje Olson
8:15-9:30 am
Creating your
Strategic Plan
Wendy Goudie
10:00-11:30 am
Methods of
Choreography
Wendy Goudie
12:30-1:30 pm
The Co-Creative
Process
Luciterra
8:15-9:45 am
Heavy Hitting Hips
Yasmina Ramzy
8:15-9:45 am
Adaptable
Choreography
Halawa
10:15-11:45 am
Pops, Locks, Ticks &
Stops
Luciterra
10:00-11:30 am
Bellyfit Live
Alice Bracegirdle
12:30-1:45 pm
Presenters Showcase
& Keynote
Doors: 7:00 pm
Show: 7:30 pm
Smart & Sassy. Signature
Choreography
Luciterra
12:30-2:00 pm
Panel Discussion
Belly Dance & Sexual
Objectification
Yasmina Ramzy, Luciterra, Wendy Goudie,
Rahel, Tonje Olson,
Halawa
2:30-4:00 pm
Sunday April 26
Personal Branding
Karen Chamberlain
8:15-9:45 am
Panel Discussion Dancing Full
Time: risks & challenges
Yasminna Ramzy, Candace
Aldridge Sanchez, Wendy
Goudie, Nicci Marsh, Rahel,
Halawa
10:00-11:45 am
Shimmy & Shake
Halawa
8:15-9:45 am
Fearless Feminity
Yasmina Ramzy
8:15-9:45 am
Creating Dynamic Tension
Tamara Dewar
10:00-11:45 am
Turn Combos into
Choreography
Kristine Jennes
10:00-11:30 am
Meaning in Movement
Yasmina Ramzy
12:30-1:30 pm
Between the Notes
Yasmina Ramzy
1:45-2:45 pm
Let's Get Lyrical
Nicci Marsh
12:30-1:45 pm
ATS Spins and Turns
Tonje Olson
1:45-2:45 pm
Bollywood Belly Dance
Wendy Goudie
12:30-1:30 pm
How to Train your Veil
Rahel
1:45-2:45 pm
Conference Prices (tax included)
Presenters Showcase $25
1 workshop
$31.50
Includes access to 1 workshop
2 workshop pass
$60.90
Includes access to 2 workshops
3 workshop pass
$85.05
Includes access to 3 workshops
4 workshop pass
$105
Includes access to 4 workshops
5 workshop pass
$126
Includes access to 5 workshops
Unlimited workshops $193.20
Includes access to all workshops and panels Saturday & Sunday
Tickets to Showcase not included
Payment Form
Total____________ (Taxes included)
IF PAYING BY CREDIT CARD
Name of Participant:_________________________________________________
Phone Number:_____________________________________________________
Visa_____ Mastercard_____
Number________________________
Expiry______________
___________________________________________________________
IF PAYING BY CHEQUE
Cheques are to be made out to Get Bent.
There will be a $25 charge on NSF chqs.
Waiver
Terms and Conditions
Registration forms received without payment will not be processed.
Safety & Code of Conduct
I hereby agree to follow all the safety policies and recognize personal responsibility for my behaviour in
BC BellyFest. I hereby acknowledge and agree that no refund will be granted in situations where I am
deemed a danger to myself and/or others and dismissed from the program. Further, I agree to cover
any expense(s) arising from such a dismissal.
Medical Emergencies
I hereby grant permission to Get Bent & BC BellyFest staff to secure proper medical treatment on my
behalf during medical emergencies and authorize all procedures without limitation, admission to an
emergency unit, and all hospital treatments as deemed necessary by the attending medical professional(s). I agree not to hold Get Bent & BC BellyFest responsible for any costs or injury arising out of
an emergency situation.
Cancellation & Refund Policies
Cancellation and refund requests must be made by email to [email protected]. Cancellations
will not be accepted via telephone or voicemail.
Requests for cancellation must be received up to 15 days before BC BellyFest and are subject to a 50%
cancellation fee. If we can fill the space(s) cancelled, only and administrative fee of $20 will be charged.
Your email request must state your acceptance of this cancellation fee. After we receive your
email request, we will send you an email confirmation.
Refunds will not be granted for requests received less than 15 days prior to BC BellyFest.
Once BC BellyFest is in session, refunds will not be provided. However, workshop substitutions will be
accepted while the conference is in session (space permitting).
Workshop Cancellations
In the unlikely event a specific workshop is cancelled or an instructor is unable to attend due to unforeseen circumstances, refunds will not be provided. However, BC BellyFest will provide alternative workshops and allow participants to change to other sessions (space permitting).
Meal & Show Tickets
Substitutions and/or refunds are not provided for meals or show tickets.
WAIVER
Those with suspected or known medical conditions should seek the advice of a physician BEFORE registering and participating in BC BellyFest.
I wish to participate in BC BellyFest and may do so only upon agreeing to the following conditions:
ACKNOWLEDGEMENT - HEALTH & SAFETY:
I certify that I have recently consulted my physician and I am in good health and have no physical condition that would endanger me while participating in the activities of BC BellyFest.
I understand staff at BC BellyFest cannot assess and monitor my physical and psychological health limits. Therefore, I am solely responsible for my own health and safety which includes, but is not limited to,
assessing the risks activities pose to me, choosing activities that are within my limits and abilities..
I agree to follow the directions of the instructors, and wear appropriate clothing for the activities. I will
also keep myself properly nourished and hydrated.
ASSUMPTION OF RISK - WAIVER OF LIABILITY:
I understand there are inherent risks and dangers associated with any exercise - including belly dance.
Further, I understand these risks include - but are not limited to - aggravating pre-existing injuries, severe personal injury and death.
I understand and voluntarily accept these risks and deliver this WAIVER AND RELEASE so that I may
participate in the exercises and activities at BC BellyFest.
In order to participate in BC BellyFest, I hereby WAIVE AND RELEASE any and all claims that I have or
may have in the future against BC BellyFest, Get Bent including their directors, owners, instructors, employees, volunteers, representatives, sponsors, independent contractors, successors, agents and assigns (collectively referred to as the "Releases").
I agree to WAIVE the Releases from any and all liability for any loss, damage, expense, or injury that I
may suffer as a result of my participation in BC BellyFest due to any cause whatsoever, including negligence on the part of the Releases and failure on the part of the Releasees to safeguard and/or protect
me from the risks and dangers referred to above, and including any duty of care owed under the Occupiers Liability Act, R.S.B.C. 1996, c337. This WAIVE AND RELEASE includes any and all claims, costs,
liabilities, expenses and/or judgments, including but not limited to attorney’s fees and court costs (collectively "Claims").
* This Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators,
assigns and representatives in the event of my death or incapacity
* This Agreement shall be governed by and interpreted solely in accordance with the laws of the province of British Columbia and shall be within the exclusive jurisdiction of the province of British Columbia
* Any litigation involving the parties to this Agreement shall be brought solely within the province of British Columbia and shall be within the exclusive jurisdiction of the Courts of the Province of British Columbia
PHOTO & VIDEO RELEASE
I understand while I am attending BC BellyFest photographs and/or videos may be taken of the participants - including myself.
I agree BC BellyFest and Get Bent may take photographs and/or videos that include my image. These
photographs and/videos may be used by BC BellyFest and Get Bent for promotional, educational, and
informational purposes including, not limited to, brochures, websites, newsletters and press without
compensation to me of any kind.
These photographs and/or videos are the sole intellectual property of the BC BellyFest and Get Bent.
PRIVACY POLICY
BC BellyFest and Get Bent does not sell or give out your personal information. All information collected
is used solely for registration and our internal contact purposes with you.
IF THE PARTICIPANT IS UNDER 18:
Please contact Get Bent for a parental/guardian consent form:
Get Bent
250-462-1025
[email protected]
_________________________________________________________________________
By signing below, I confirm that I am 18 years old or older and I have read and understand this Agreement. Further, I understand that by agreeing to these conditions I am waiving certain legal rights which I
or my heirs, next of kin, executors, administrators, assigns, and representatives may have against the
Releases.
[ ] I have read, understand and agree to the Waiver, Photo & Video Release, and Privacy Policy
Date:_________________________________________
Participant Name:_______________________________ Signature:__________________________