Mail-in Event Registration

Print this form and mail to the address below with check payment.

Category	Cost	Quantity	TOTAL	(AT DOOR)
Adult - All Event	$40.00			$45.00
Youth - All Event	$25.00			$30.00
Friday Night	$20.00			$25.00
Saturday & Sunday ALL DAY	$35.00			$40.00
Saturday - ALL Day	$25.00			$30.00
Sunday - All Day	$25.00			$30.00
	Grand Total Total:_____________

Name
Address
City	State	Zip
Phone		E-Mail

Dance Level: (circle one) BEG - PLUS - ADVANCED - CHALLENGE

Club & Association

Pre-Registration deadline: April 23, 2010

NO REFUNDS AFTER April 23, 2010
A $5.00 fee will apply to ALL refunds

Make checks payable (one check for all events/ribbons) to:

2010 Golden State RoundUp

Mail to:
Stephen Bath
P.O. Box 3741
Walnut Creek, CA 94598

E-mail

Last revision: November 30, 2009