" DANCE-OPOLY "
SATURDAY JUNE 4, 2011 SOLD OUT
Name____________________________________________________ Date____________________
Address ___________________________________________________________________________
City______________________________________ State _______________Zip ________________
E-mail ___________________________________________Phone ( )_________________
Dance Level __________ Beginner __________ Intermediate/Advanced
| ***** | CHOICE | PRICE | AMOUNT PAID |
| ***** | POSTMARKED BEFORE MAY 1, 2011 | | |
| ALL DAY WORKSHOP, DINNER & DANCE | $45.00 | |
| ALL DAY WORKSHOP & DANCE | $40.00 | |
| WORKSHOP ONLY | $35.00 | |
| ***** | POSTMARKED AFTER MAY 1, 2011 | | |
| ALL DAY WORKSHOP, DINNER & DANCE | $50.00 | |
| ALL DAY WORKSHOP & DANCE | $45.00 | |
| WORKSHOP ONLY | $40.00 | |
| ***** | ANYTIME | | |
| DINNER AND DANCE ONLY | $15.00 | |
| DINNER ONLY | $10.00 | |
| Menu: still in planning stage |
| ***** | CASH $__________ CHECK #__________ | $_______ | |
| | TOTAL | $_____________ |
Please make check payable to FTLD (Funtime Line Dancers)
I the undersigned , agree to hold organizers of Funtime Line Dance Extravaganza, Lakewood Elks and their agents harmless from suits, claims and demands of every kind and character arising out of and in conjunction with this event. I acknowledge there are no refunds after MAY 1, 2011. Registration numbers are limited.
Signature______________________________________________ Date________________________
*****Please use one form per person. Confirmation will be by e-mail or phone.*****
Mail Registration to: Cathy Harris
1619 Firlands Drive S.
Tacoma, WA 98405