Mezdulene's 20th Annual Retreat
NAME(S)______________________DANCE NAME(S)___________________
E-MAIL ADDRESS________________________________________________
ADDRESS__________________________CITY/STATE/ZIP________________
PHONE______________YOUNG CHILD__ ROWDY CABIN__ QUIET CABIN__
I WANT TO BE IN CABIN WITH:_____________________________________
| COST: | Until August 30, 2009 |
After August 30, 2009 |
| ____Dancers (includes workshops) | $125.00 | $150.00 |
| ____Daughters and Granddaughters | $65.00 | $80.00 |
| ____Non-dancers (no workshops) | $85.00 | $95.00 |
| ____Vending Table | $50.00 |
I am enclosing: $________ No Refunds after Aug. 15, 2009
Credit Cards Now Accepted
Credit Card Number_______________________ Expiration__________
Please remit to Mezdulene, P.O. Box 680, Sutherlin, OR
97479.
Questions? Call (541)459-3115