Registration

Print this page (or download the whole flier) and mail it with your check to the address at the bottom. A copy of the ball booklet with instructions for all dances will be mailed to registered dancers beginning in April. For more information, e-mail MadRobinBall@aol.com or call Gayle Bergmann.

Name(s) for nametag(s) ______________________________________________________

Address __________________________________________________________________

City ___________________________________ State ___________ Zip ________________

Telephone _____________________________ Email ______________________________

Make check payable to Mad Robin Ball.

I'd like to volunteer to help ____ beforehand ____ that afternoon ____ at the ball

To register, mail this form and your check to:

Gayle Bergmann
3639 Frei Rd.
Sebastopol, CA 95472

Last modified 3/26/02 by MRB webmaster