Winter WarmUp Registration

NAME:_____________________________________________
ADDRESS:__________________________________________
CITY, STATE, ZIP:_________________________________
TELEPHONE:________________________________________
EMAIL:____________________________________________
Check as needed
Do NOT print my address___ phone___ email___ on attendee list.
Yes, I need housing___Sleeping bag space OK for___#of people
Prefer bed space for ___#of people.
Type and number of beds needed (twins, double, etc.)______________
I prefer: Smoking____Non-smoking____Pets OK____Allergies?______
Special needs?______
I am attending the weekend with and wish to be housed with (names)______

Please help us by registering early. Walk-ins are welcome. Registrations must be postmarked by November 17 for earlybird discount. Working scholorships are available. Please contact Beth at (614)870-7580
Print out this form and mail to the address below, with your check payable to Big Scioty Barn Dance to:
Winter WarmUp
c/o Dave Notman
5278 Timberline Road
Columbus, OH 43220-7306