April 19th - 22nd, 2012

Ellenville, Catskill Mts, New York
Phone: 1-866-345-6028

Tim Gillis accepts Visa, Master Card, American Express and Discover credit cards

PLEASE READ AND FOLLOW THESE INSTRUCTIONS!!
You must do 2 things in order to register and pay for this event:
You have to REGISTER AND You have to PURCHASE!

1) REGISTER FOR THE EVENT
Fill out the registration form on this page and click on the "Submit to Tim Gillis" button at the BOTTOM of this page. This will send you to the Online Registration Confirmation page. On that page you can double check what you sent, then click on the link that says "Make Your Purchase". That will bring you to the Tim Gillis Spring Dance Weekend Credit Card Purchase Page to make your purchase.

2) MAKE YOUR PURCHASE FOR THE EVENT
Go to the Tim Gillis Spring Dance Weekend Credit Card Purchase Page. Use the 'Buy Now' buttons to make your purchase using Tim's new secure shopping cart. Just click on the button next to the item(s) you wish to pay for. You will be taken to the Tim Gillis Dance Weekends' shopping cart. If you wish to return back to that page before you make your final purchase, just click on 'Continue Shopping' which is at the bottom of the shopping cart.

DID YOU READ THE INSTRUCTIONS?
IF NOT, PLEASE GO BACK AND DO SO!

E-mail: (required field)

Event:

Venue:

Name: (required field)

Street Address:

Any Additional Address Information:

City:

State/Prov:

Zip/Postal:

Home Phone:

Business Phone:

Mobile Phone:

Verify E-mail:

How many nights will you be staying? (please choose from the list below)
3 Nights - Thursday Friday, Saturday 2 Nights - Friday & Saturday 1 Night - Friday Only	0 Nights - Daytimer Only 0 Nights - Evening Dancer Only

If you are a Daytimer or an Evening Dancer Only, after you choose your pass in the next section, you can skip the Room Selections and continue filling out the form.

If you chose the 2 or 3 night stay, you can move right down to the Room Choices.

If you chose the 1 night stay, you can skip both the Daytimer and Room sections.

Saturday Daytimer Passes

$135 per person - this rate includes Rosie Multari's Zumba Warm-Up, all other lessons offered, full program book with all the dance scripts (now on CD), lunch & dinner, the Saturday evening dance & show, plus the late night snack menu (to be determined) & Karaoke!

$75 per person - this rate does includes everything you see mentioned above, however with this rate there is NO FOOD INCLUDED

Please choose which Price Rate:

$135 (Food Included)

$75 (No Food)

Friday & Sunday Daytimer Passes

$50 per person for each day - this rate includes all dance lessons, all open dances that day, full program book with all dance scripts (now on CD). You can also add Friday Dinner for $30.00, Sunday Breakfast for $15.00 and Sunday Lunch for $25.00 (Meal arrangements can be made at the Front Desk when you arrive). If you come on Friday, it includes the Friday Night Demos, if you come on Sunday, it includes Rosie Multari's Zumba Warm-Up.

Please choose which Day(s):

$50 Friday

$50 Sunday

$100 Both Days

Thursday, Friday & Saturday Evening Dance Only Passes

$20.00 per person for Thursday Night or Friday Night. $30.00 per person for Saturday Night, which also includes the Saturday Night Instructor Showcase.

Please choose which Night(s):

$20 Thursday

$20 Friday

$30 Saturday

Hotel Room Selection & Bed Choices

The Room Choices, availability of King Size Beds and Seating preferences are limited and they are assigned based on the date you reserve and the amount of nights you plan on staying. Tim Gillis and Rosie Multari will do their best to honor your requests.

All rooms have either two Double Beds or a King Bed but Executive rooms are larger and Suites are even more spacious.

If you are only staying 1 night, you can skip over the room selection and bed choices. The One Night Package does not offer the luxury of being able to make these choices.

Select Room Preference:
Deluxe Room Single Deluxe Room Double Deluxe Room Triple Deluxe Room Quad	Executive Room Single Executive Room Double Executive Room Triple Executive Room Quad
Executive Suite Single Executive Suite Double Executive Suite Triple Executive Suite Quad	VIP Suite Single VIP Suite Double VIP Suite Triple VIP Suite Quad

What's more important:	Preferred Bed Choice:
Room Type Near Your Group	2 Double Beds 1 King Bed

If you are paying for someone else please give their full name(s). If
they want a separate reservation confirmation mailed to them you
must include their mailing address so Tim Gillis can send them one:

If you are rooming with someone please give their full name(s):

Please list Names/Group you wish to sit with:

Please list special needs or diet requirements:

Please list name(s) you want on name tag(s):

Tim Gillis Golf Tournament

* Will You Be Playing Golf:

Yes

Tim Gillis Spring Dance Weekend Step Sheet Booklet

* Do you want to buy a Step Sheet Booklet:

Yes

If you chose Yes, please remember to PAY for your Step Sheet Booklet (in addition to your deposit) when you get to the Credit Card Purchase Page. You must include this amount with your deposit. A PDF version of the entire booklet as well as individual PDFs of the step sheets will be available on the web site shortly before the start of the event.

Pre-Order Fall Weekend T-Shirts

Pre-Order Weekend T-Shirts and you can make sure that we have your size and you can save money too!! Weekend T-Shirts will be $15.00 at the event. Pre-Orders will be $12.00 per shirt (prices good for all sizes up to XL - 2XL or 3XL Add $2.00)

Sm:

Med:

Lg:

XL:

2XL:

3XL:

Please choose a quantity for each T-Shirt Size you are purchasing. T-Shirts have to be ordered, so please remember to PAY for your T-Shirt (in addition to your deposit) when you get to the Credit Card Purchase Page.

If you have gotten this far you are now ready to submit your registration to Tim Gillis. Just Click on the "Submit to Tim Gillis" button below. AFTER you do that you then need to proceed to Step 2 which is make your Purchase. You have to go to the Tim Gillis Fall Dance Weekends Credit Card Purchase Page. There you will be able to make your purchase for the event or just make a deposit.

A MINIMUM DEPOSIT OF $70.00 PER PERSON REQUIRED!

The e-mail created and sent to Tim Gillis when you submit this form goes to E-mails Servers required to be H.I.P.A. compliant. This refers to what is known as the Health Information Protection Act. It requires that there be a 128 bit encryption in all e-mails coming and going from the e-mail servers.

* * Important Note:
When you click on the 'Submit to Tim Gillis' button, it will then send an e-mail to Tim Gillis at this e-mail address: timgillis@timgillisdanceweekends.com. The next thing that happens is that you will be taken to an 'Online Registration Confirmation' page. If none of this occurs then the information was not sent to Tim Gillis. If that happens you can try to submit the form again or please contact Tim Gillis directly.

timgillis@timgillisdanceweekends.com ~ timgillis@aol.com
1 (732) 855-0075 • 1 (800) TGB-EVENT (842-3836)