GR Squares Flyin Registration Form

Grand River Squares Flyin 2008 Registration Please register before March 29, 2008 to reserve a seat at brunch!
First Name:
Last Name:
Address Line 1:
Address Line 2:
City:
State/Province:
Zip/Postal Code:
Phone:
Email Address:
Club Affiliation:
Dance Level: (circle highest level)	MS PLUS A1 A2 C1 C2
Please complete the following to request housing with our club members. Registration must be paid before March 15th to ensure housing arrangements.
I will need housing on:	Friday Saturday Sunday
I am a:	Male Female
I am a:	Smoker Non-smoker
I would like to stay with a:	Male Host Female Host No Preference
Restrictions (pet allergies, etc.):
I have arranged to stay with :
Registration Fees:
Early-Bird Registration (Before March 15th)	$65.00 USD
Full Registration (After March 15th)	$80.00 USD
Widow/Non-dancer Registration	$25.00 USD
Please make your check payable to "Grand River Squares" and mail to: GRAND RIVER SQUARES PO Box 140792 Grand Rapids, MI 49514-0792