Mid-Ohio Boogie Bash 2016

Registration Form

Scroll down to see the form

Note: If you would like to use PayPal, then this form is not needed. Please use “Get Your Ticket”, and indicate your purchase request at the bottom of the page. Thank-you.

 

---

• Name - Ticket 1 First Last
• Address
  Street Address
  City State Zip
• Contact Information We will only email for items related to Mid-Ohio Boogie Bash. Phone Email
• Name - Button Information Enter your first name as you would like it to appear on your name button First Last
• Your Club Affillation
• Name - Ticket 2 First Last
• Address
  Street Address
  City State Zip
• Contact Information We will only email for items related to Mid-Ohio Boogie Bash. Phone Email
• Name - Button Information Enter your first name as you would like it to appear on your name button First Last
• Your Club Affillation

---

Early-Bird Prices are no longer available

After July 11^th 2016

The weekend Passes will be $105.00 and Day Passes are $90.00

 

Ticket Type	Number of Tickets Requested
Weekend Pass		$105.00 each	$
Friday – Day Pass		$90.00 each	$
Saturday Day Pass		$90.00 each	$
Total			$

---

Mail the filled out registration form, your check made out to “Mid-Ohio Boogie Bash”, and a self-addressed stamped business-size envelope to:

---

Mark your calendar for Augist 11^th through August 13^th, 2016

Copyright © Mid-Ohio Boogie Club 2016