Fire Ant Frolic 2017
Online Registration

Required fields are in BOLD

First Name:      Last Name: 
As you want it on your name badge
Do NOT share personal information
Street  
City  
State  
Zip  
Email  
Home Phone      (format: 123-456-7890)
Cell Phone      (format: 123-456-7890)
Additional Dancers
First Name Last Name Email
Notes  (max length = 1000 chars)

Hospitality Limited home hospitality for 2 nights is available on a first come, first served basis.
Hospitality Request: Number of Beds  
Hospitality Request: Smoker
Hospitality Request: Cats OK
Hospitality Request: Dogs OK
Hospitality Request: Transportation
Hospitality Request: Notes (Allergies, etc.)  (max length = 500 chars)

Hospitality Offer: Number of Beds  
Hospitality Offer: Smoker
Hospitality Offer: Have Cats
Hospitality Offer: Have Dogs
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
T-shirts available in Men's style only.
See sizing chart on T-shirt page.
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
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 1.3.4