2006
Complete
this form and enclose payment. Your event passes will be waiting upon arrival.
Absolutely no refunds under any circumstances.
Name ______________________________
Address ______________________________
City, State ______________________________ Zip ________________
Phone ______________________________
E-Mail Address ______________________________
Submission of this form by the
party or parties listed above signifies the following statement:
“We agree to hold the organizers
of this event and their agents harmless from all suits, claims, or demands of
every kind and character arising out of and in conjunction with this event. We
hereby authorize the reproduction, sale, copyright, exhibition, broadcast,
and/or distribution of any videotape without limitations. We understand the
physical risks of entering dance competition and social dancing and assume full
responsibility for any injury or personal damages resulting from the event
named above. We certify that we are 18 years of age or older (applicable to
Legal Guardian if under 18 years of age.)”
Signature ______________________________ Date ________________
|
EVENT FEES |
||||
|
Please
Select From The
Following |
Qty |
Before 10/1 |
After 10/1 |
Total |
|
Weekend Event Pass Admission to all free activities, including 3-day event
pass, all workshops & nightly dances. |
|
$70 |
$80 |
|
|
LDI Member Event Pass Same admission as Weekend Event Pass. LDI MEMBERSHIP #
____________ |
|
$65 |
$75 |
|
|
Junior Weekend Event Pass Ages 15 & Under. |
|
$35 |
$40 |
|
|
Saturday Only Pass Admission to all free
activities, workshops & dance. |
|
$45 |
$55 |
|
|
Dinner & Show
|
|
$25 |
$30 |
|
|
Friday
Night Pass (5PM - Close) |
$15 |
$20 |
||
|
Saturday Night
Pass (5PM - Close) |
$15 |
$20 |
||
|
Step Description Booklet $2.00 off to LDI members. |
|
$12 |
$15 |
|
| Workshop & Show Video |
$50 |
$55 |
||
|
Workshop Video (VHS or DVD same price) Please indicate VHS or DVD when ordering Price Includes USPS shipping in the |
|
$40 |
$45 |
|
|
Miscellaneous |
|
|
|
|
|
TOTAL EVENT FEES |
|
|||
Make checks or money
orders payable to: Tampa Bay Line Dance Classic
Mail payment to:
Jennifer Cameron
1724 NW 72nd Ave.
Plantation, FL 33313