21^st Annual Trail of Tears Pow Wow

September 6 & 7, 2008

Hopkinsville, Kentucky

d_midge@bellsouth.net

Dancer Registration Form

The Hopkinsville Trail of Tears Commission, Inc.  would like to invite you to pre-register for the 21 ^st Annual Trail of Tears Pow Wow in Hopkinsville, KY.  This will allow some extra travel time for you and your family.  This will also insure your registration for the competition.  Should you have any questions, feel free to email me at the above email address.  We look forward to seeing you at the Pow Wow and working with you and your family.  You will receive confirmation either by mail or email that your registration has been received.

Please fill out the bottom portion of this form and return to the address below. There is no registration fee this year for all dancers :

Midge Durbin

2805 Canton Pike

Hopkinsville KY 42240

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Name: ______________________________________________________ (Please Print)

Address: ____________________________________________________

            City: _______________________     State: ________          Zip Code:_________

            Phone Number: _______________          Cell/Work Number: ________________

Tribal Affiliation: ___________________________ Email Address:___________________________________

I will be dancing in competition for prize money.  (Please check one of the following.)  Yes__  No__

Adult Competition:         Dancers 18 years of age and older

Junior Competition:         Dancers 11 years of age to 17 years of age

(Proof of age may be required)

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Category Entered:  (Please circle only one)