Registration Form

Independence Celebration BBQ & Dance Party

Saturday, July 5, 2008

at the Arlington Lodge, 56 Pond Lane, Arlington MA

Registration Form

Name(s): __________________________________________________________________

First Time Dancer Name(s): _______________________________________________________

Phone Number: ___________________________________

Email Address: ___________________________________

	Until July 1st	After July 1st	Quantity	Total Amount
All Day Pass with Barbeque	$25	NA	.	.
All Day Pass without Barbeque	$20	$20	.	.
Dance Only (includes beginner lesson)	$10	$10	.	.
All Day Pass with BBQ for first time dancers**	$15	NA	.	.
** Never danced WCS before.		Grand Total:	.	.

Please register in advance if you plan to attend the BBQ...June 28th by mail or July 1st in person.

Please make check payable to: Neal Klein
Please hand in or mail your registration and payment to:
Jon Schimmel, PO Box 812433, Wellesley, MA 02482