Winter Dance Weekend Registration Welcome to registration for Winter Dance Weekend! Registration for Winter Dance WeekendInstructions First Name *Last Name *Email *Phone Address City State Zip Are You a Contra Borealis Dancers member? Members receive $5 off their registration for the weekendYesNoNo, but I'll purchase one ($15 young adults 25 or younger, $20 adults)Dietary restrictions/preferences We will be hosting a 'bring if you can' potluck Saturday night. We will do our best to accommodate dietary preferences, but cannot guarantee availability.NoneVegetarianVeganGluten freeKosherOtherIf you are coming from out of town, would you like housing assistance? YesNoThursday House Concert Would you like to to purchase a ticket to the Thursday night house concert with Max Newman and Julie Metcalf?Yes, I will add $15 to my registration feeRegistration fees $75 Weekend 35 and older, non-members$70 Weekend 35 and older, Contra Borealis members$45 Weekend Under 35, for non-members$40 Weekend Under 35, for Contra Borealis membersUnder 16: Free!Contra Borealis Dancers membership: $20 for 26 years of age and older / $15 for younger folks$15 Thursday night concert all agesPayment If by check, mail to: Contra Borealis Dancers. Box 84084, Fairbanks, AK 99708 --- Refund policy: Contact David Kreiss-Tomkins at 907-738-5883 or email@example.com for a refund of registration fees. Full refunds are available before January 15th, 2018; half your registration fee is refunded afterward.Paying by checkPaypal/credit cardTotal Amount Due VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>: Once you submit this form, you should automatically be redirected to our payment page.