Registration
Father/Daughter Dance 2019 $45 per Father/Daughter $50 for 2 daughters $55 for 3 or more daughters **Includes dinner and souvenir digital photo
Event:
Start Date/Time: End Date/Time:
Fee per Family: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info
(Not Contact #1 or #2)
 
 
 
Questions/Options:
Price includes BBQ dinner that is served anytime between 6 - 7 pm as well as a souvenir digital photo. Games throughout the night and square/line dancing offered towards the end of the night!
Add on the Ultimate Country Package? $15 A digital portrait of just your daughter, a trip to the Candy Buffet, entrance for dad and daughter(s) to the cupcake walk, and a country-themed ornament.
How many daughters/grand-daughters will you be bringing to the dance?*
How did you hear about the event?
 
Additional Information:
 
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number:  
Name as it appears on card:
Nickname:
Card Expiration Month:   Exp Year:
Address Line 1: Address Line 2:
City: State: Zip: