Danceland Weekend
Registration Form
June 23 - 24 - 25 2011
Please complete form & mail early !
| Surname | ||
| His | ||
| Hers | ||
| Address | ||
| Postal Code | ||
| Telephone | ||
| Badges @ $6.00 each | _______X $6.00 = | |
| Dance Fee: Full Weekend $55 / couple. Dance Fee: Single Session $12 / session |
_______ X $55 = _______ X $12 = |
Total = ___________ |
Payable to: |
Tele: 306-436-4615 |
Shirley Treleavan Box 233 Milestone Sk. S0G 3LC |
E-mail: treeline@hotmail.com. |