Hustle Halloween 2008 Registration Form

Hustle Halloween 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_________

Hustle Halloween is $119 when postmarked by Oct. 14, 2008

Please circle the passes you are purchasing:

Weekend Pass ~ all inclusive $139
Daily Pass good from 9am ‘til 5am the next morning $80
Evening Dance Passes 8:30 pm ‘til 5am $25
Non Dancer Spectator Passes: Day Pass $20 ~ Weekend Pass $50
Chaperone Non Dance Spectator Passes: Day Pass $10 ~ Weekend Pass $25

No refunds or substitutions

Central Coast Swing Dance, 333 Rice Ranch Rd,
Santa Maria, CA 93455

Phone: Debra Hampton @ (323) 459-6713

Registration E-Mail: ccsd@thegrid.net

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