REGISTRATION FORM
Southern Rhapsody Dance Society’s Big Band Dance Weekend
Print this form then fill it out and mail it

RESERVED SEATING ONLY “LIMITED AVAILABILITY”

Circle which Dance(s) you wish to attend.   

Nashville   Indianapolis-

Name__________________________________________________________________________

Address________________________________________________________________________

City, State, Zip_________________________________ Phone # (____) ____________________

E-mail__________________________________________________________________________

Amount Enclosed $_______________ ($200 deposit or $625 Full payment) Mail Check or

Charge to my Visa, Master Card or Discover(circle one) Card #_____________________________

Expiration Date ____/_____

Signature______________________________________________________________________

E-mail _________________________________________________________________________

Seat me with ___________________________________________________________________

_______________________________________________________________________________

Mail to:
Southern Rhapsody Dance Society,
P.O. Box 87
Pleasant View, TN 37146

Telephone Reservations

877-212-6555 toll free (6-9pm CST,M-F) 

Fax Reservations with Master Card/Visa or Discover Card information to:
615-746-9755 anytime.

DO NOT E-MAIL RESERVATIONS

Click here for Cancellation Policy Click here to Go back to Home