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Manatee Madness Ballroom Dance Festival

Summary of Purchases & Payments (Please type or print)

Deadline is August 15, 2011

~~ Packages may be picked up at the Hotel Party Friday Evening/At the Door Saturday or Sunday for Congress ~~



Studio: _____________________________________________________________________

Address: _________________________________________________________________

City: ________________________ State: ____________________ Zip: ____________

Primary Contact: ___________________________ Phone/Cell: _____________________

Email: __________________________________________



Manatee Package: (add extra lines as needed)


Full Name(s): _________________________________     Full Name(s): _________________________________

Full Name(s): _________________________________      Full Name(s): _________________________________

Full Name(s): _________________________________      Full Name(s): _________________________________

Full Name(s): _________________________________      Full Name(s): _________________________________

Total Person(s): ________________      Total $ Amount: ________________

A-La-Carte

Congress (Lunch Included): (Add extra lines as needed)


Full Name(s): _________________________________     Full Name(s): _________________________________

Full Name(s): _________________________________      Full Name(s): _________________________________

Full Name(s): _________________________________      Full Name(s): _________________________________

Full Name(s): _________________________________      Full Name(s): _________________________________

Total Person(s): ________________      Total $ Amount: ________________


General Spectator Tickets: (please list amounts)

Morning: ____________

Afternoon: __________

Full Day: ___________

Total Person(s): ________________      Total $ Amount: ________________


Saturday Lunch Buffet:

Total Person(s): ________________      Total $ Amount: ________________


Saturday Evening Dinner Dance and Show Tickets:


With Dinner: ______________

W/O Dinner: ______________

Total Person(s): ________________      Total $ Amount: ________________

Extra Programs: ____________


GRAND TOTAL $ AMOUNT: _____________________



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