Application Diva Intensive Retreat
Diva Dancer Intensive Performance Styling Retreat
Friday – Monday, May 22-25, 2026
Ma*Shuqa Mira Murjan & Carl Sermon Photography
Our Studio: 15651 Camino Del Cerro, Los Gatos, CA USA 95032
I wish to enroll in the Diva Dancer Performance Styling Intensive Retreat, May 22 - 25, 2026 in Los Gatos, California
Enrollment limit: 6 students
Tuition:
Only $500.00 per dancer for the Diva Dancer Intensive Retreat
Credit card payment via Square invoice . or
Checks payable to: Reel Sound and Light Productions Check #______________
** Make a non-refundable deposit of $100.00 (deposit transferrable), payable by check or credit card with the application to receive the Early Bird price of only $400.00 for the Diva Dancer Intensive Retreat. The balance of $300 is to be paid in full by January 30, 2026.
After the January 30, 2026, balance due of $400 must be paid by May 1, 2026, to secure enrollment (payable by check, credit card, or Square.com Invoice).
Mail to: 15651 Camino Del Cerro, Los Gatos, CA 95032-3721 MaShuqaDancer@gmail.com
Application
Telephone: +1 408-356-9473
E-mail: MaShuqaDancer@Gmail.com
Address: 15651 Camino Del Cerro, Los Gatos CA 95032
Application for Diva Retreat
Dance Student/Performer Liability Release Form
This release form must be completed and submitted with final tuition balance due on May 1, 2026.
Please click on the button to be transfered to the Liability form page.
Diva Intensive Retreat Form
This form may be copy & pasted into e-mail
Dance Name ________________________________________
First Name ___________________________ Last Name _________________________
Street Address__________________________________
City_________________________________________State______ Zip__________
E-mail___________________________
Confirn E-mail______________________
Mobile______________________________ Land Line__________________
Please describe any allergies, food allergies, vegan, and/or health conditions
____________________________________________________________________
_____________________________________________________________________
____________________________________________________________________
Emergency Contact Info:
Name and Relation ____________________________________________
Street Address ___________________________
City __________________________________State_____Zip______
Mobile/Landline______________________________________