Registration

Print this page (or download the flyer) and mail it with your check to the address at the bottom. A copy of the ball booklet with instructions for all dances will be mailed to registered dancers beginning in April. For more information, e-mail tspittler-at-yahoo.com or call Tom Spittler and Kathy Woeltjen at 707-829-0168.

Name(s) for nametag(s) ______________________________________________________

Address __________________________________________________________________

City ___________________________________ State ___________ Zip ________________

Telephone _____________________________ Email ______________________________

 

Cost

 

Number

Total

Early registration, postmarked by June 1

$20

  _____ _____

Registration after June 1(if not sold out)

$25

  _____ _____

Gallery (non-dancer)

$10

  _____ _____

Additional donation

    _____
 

I am enclosing

_____

Make check payable to Mad Robin Ball.

I'd like to volunteer to help ____ beforehand ____ that afternoon ____ at the ball.

I will bring something ____ sweet ____ savory to share at the break.

To register, mail this form and your check to:

Mad Robin Ball
185 Dutton Ave.
Sebastopol, CA 95472

Last modified5/26/05 by MRB webmaster