Fire Ant Frolic 2018
Online Registration

Required fields are in BOLD

First Name:      Last Name: 
First Name Last Name
Do NOT share personal information
Street  
City  
State  
Zip  
Email  
Home Phone      (format: 123-456-7890)
Cell Phone      (format: 123-456-7890)
Notes  (max length = 500 chars)

Hospitality Hospitality Request: Number of People  
Hospitality Request: Number of Beds  
Hospitality Request: Smoker
Hospitality Request: Cats OK
Hospitality Request: Dogs OK
Hospitality Offer: Number of People  
Hospitality Offer: Number of Beds  
Hospitality Offer: Smoker
Hospitality Offer: Have Cats
Hospitality Offer: Have Dogs
Hospitality Notes  (max length = 500 chars)

Attendance and Merchandise
Option Price     Qty
Adult $95
Student (13 and up) $45
Child 12 and under if dancing $25
Child 12 and under if not dancing $0
Members of TAADA, AFTM or any group associated with CDSS $-5
Early Registration Discount $-5
Men's T-shirt Small $15
Men's T-shirt Medium $15
Men's T-shirt Large $15
Men's T-shirt Extra Large $15
Men's T-shirt Extra Extra Large $15
Women's T-shirt Small $15
Women's T-shirt Medium $15
Women's T-shirt Large $15
Women's T-shirt Extra Large $15
Women's T-shirt Extra Extra Large $15
Membership: Single: $20      Family: $30
Donation (OPTIONAL, but appreciated) $
PayPal Fee (OPTIONAL, but appreciated) $0

Total $0  
Payment

Please fill in the form and click the Pay button.
You will be asked to confirm before transferring to PayPal, and you can complete or cancel the transaction in PayPal.
In PayPal you can pay via your PayPal account, or use a credit card.
No PayPal account is needed for credit card payments.
A confirmation email will be sent from both PayPal and from us when payment is completed (NO email if transaction is cancelled).

For online registration problems, please contact the webmaster: laurasw53@gmail.com

Created by GM Online Registration System, version 1.3.5