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Halloween Swingthing Registration Form
For Mail; Please Print, & Fill Out Completely
E-Mail: (credit card only)
Copy & Paste, Fill out completely

Name:

Address:

City, State, Zip:

Phone: (Day)__________________(Eve)__________________

E-mail:

Amount enclosed: $_______

Visa/Mastercard#_____________________ Exp.date_________

Halloween Swingthing is $115 when postmarked by Oct. 12, 2007
$130 per person at the door
No refunds or substitutions

Central Coast Swing Dance, 333 Rice Ranch Rd, Santa Maria, CA 93455 Phone (805) 937-1574

Registration E-Mail: ccsd@thegrid.net

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