Registration form - clip and send

Name(s): _________________________________________   

Address: __________________________________________

City/State/Zip ______________________________________                         

Phone: ________________ Email: _________________________                  

Include your email address for confirmation. Send SASE only if no email.                           

# people: ___ x $43 ($50 after April 16)  = ______ enclosed                  

Refunds minus $5 and a hug available until April 16.

Add to the Dance Rhapsody events list serve?  Check: ____

Need housing? ____No ____Yes, for ___ adults            circle:   Sharing or Separate         

Atlantans: check if you can offer housing: ____

Hospitality arrangements are nonsmoking; may include pets on premises.

Note pet allergies and other housing needs here: ______________________________________________

Make checks payable to Dance Rhapsody

Mail to:

Lalah Manly

P.O. Box 807

Pine Lake GA 30072