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 ______________________________
|  
       Cost 
     | 
    Number | Total | ||
| Early registration, postmarked by May 12 |  
       $20 
     | 
    _____ | _____ | |
| Registration after May 12 (if space available) |  
       $25 
     | 
    _____ | _____ | |
| Gallery (non-dancer) |  
       $8 
     | 
    _____ | _____ | |
| Additional donation | _____ | |||
|  
       I am enclosing 
     | 
    _____ | |||
Make check payable to Mad Robin Ball.
I'd like to volunteer to help ____ beforehand ____ that afternoon ____ at the ball.
I will bring something ____ sweet ____ savory to share at the break.
To register, mail this form and your check to:
Gayle Bergmann
  3639 Frei Rd.
  Sebastopol, CA 95472
Last modified 4/11/03 by MRB webmaster