Contact Person:

Mailing Address:

Message Phone Number:

email address:

Name of individual purchasing Ticket 1:                                   

Name of individual purchasing Ticket 2:

Number of tickets Purchased: @ $65/ticket        

Total Amount Enclosed:

Make Check or Money Order payable to BALLROOM BOOTCAMP and mail to 1299 Lloyd Thayer Circle Stockton, CA  95206

If you wish to pay by credit card, there is a $3 processing fee per ticket. To pay by credit card, visit www.paypal.com and click on the SEND MONEY tab. Enter the email address thestocktonshowcase@gmail.com Next, enter your email address and the amount of $68/ticket. Click continue. Follow the onscreen instructions.

CASH payments are only accepted in person. Call Cathy at 209 406-9239 to schedule a time to meet at 1299 Lloyd Thayer Circle to deliver your payment.

If you are planning to perform a routine in the Showcase, please complete this section:

Name of Student(s):     

Name of Teacher:

Name & Location of Studio:

For each routine, list the following information:

Level of Skill (Newcomer, Pre-Bronze, Bronze, Silver, Gold)     Style of Dance (Waltz, Tango, Salsa)

1.                                

2.