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|
1st Adult Name ____________________________________ |
( ) M ( )F |
( ) member |
( ) non-dancer |
|
2nd Adult Name ___________________________________ |
( ) M ( )F |
( ) member |
( ) non-dancer |
|
Name ___________________________________ |
Age _____ |
|
Name ___________________________________ |
Age _____ |
|
Name ___________________________________ |
Age _____ |
|
Name ___________________________________ |
Age _____ |
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Street _________________________________ |
City ______________________ |
State ____ |
Zip __________ |
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Phone ___________________________ |
|
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( ) Mixed-gender cabin |
( ) Single-gender cabin |
( ) Family cabin |
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( ) RV/camper |
( ) Tent |
( ) None |
|
Omnivore _______ |
Vegetarian _________ |
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Special needs: |
________________________________________________________________________ |
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Amount enclosed: |
$_____________ (Payable to NM FolkMADS) |