✅ Holiday Inn Clark ~ Friday, November 22 ~ Event Registration / RSVP: Dance Party & Social with Cha Cha Lesson
$18 admission at the door without preregistration thru this Google Form

OR

$16 admission at the door for one with this Google Form Registration by Friday, November 22

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By completing this form before 9am on the day of this event, your name will be on the GREEN LIST.

Privacy Policy: Information provided is not sold or used except for notification of future events & related communication
Email address *
Confirm Email address *
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First Name *
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Last Name *
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Zip Code *
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Cell Phone Number *
xxx-xxx-xxxx
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Gender *
How did you learn about tonight's event *
What Dance Instruction(s) would interest you at future events
🎁 What is your Birthday?
mm/dd/yyyy
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Notes
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CONFIRMATION
Upon successful submission of this form, you will receive an email with a copy of this form including your responses as confirmation that your RSVP was received by PBSN. When you arrive at the event, tell the Greeter that you are on the GREEN LIST. Questions: email PBSNgatherings@aol.com or call 610-348-5544 or 845-402-1364. See you at the event. Respectfully, Your Organizer, Ralph
More events visit: www.PBSNinfo.com
Directions: http://www.pbsninfo.com/forsgateccmonroe.htm
A copy of your responses will be emailed to the address you provided.
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