2017 NUTCRACKER ON ICE

FOR GIRL SCOUTS

December 8 & 9 2017

Registration Form

·  Tickets on sale now. Forms may be submitted by email or in person. Orders will be processed on a first-come, first served basis. If you do not receive an email confirmation that your form has been received within 5 working days, please email to confirm that we have your reservation.

·  Girl Scouts may register as a troop or as individuals with a credit card payment. . Contact Mo Browning to handle payment by calling or sending her this registration form. She can be reached at the email above. She will send you confirmation with your online tickets once they have been processed.

·  All fees include a GirlScout patch for attending the show.

·  If you are registering for two different workshop/show times, please use a separate form for each one. No refunds unless the event is canceled. Add-ons made on a space available basis.

NUTCRACKER ON ICE

FOR GIRL SCOUTS

December 8th & 9th, 2017

Registration for: / [ ] Troop (Troop Number ______) [ ] Individual Girl Member
Troop Leader or Parent (Responsible Adult) Contact Information:
Name:
Address:
City: / State: / Zip:
Preferred Phone #: / Preferred Email Address:
Role: / [ ] Troop Leader / [ ] Parent / [ ] Other (pls describe):
Workshop/performance requested: [ ] FRIDAY 7PM [ ] SATURDAY 1PM [ ] SSATURDAY 6PM
# of registered Girl Scouts: / x $10 / + $1.75 per ticket = / $ / Total for Girl Scouts
# of adults / tag-a-longs: / X $12 / + $1.75 per ticket = / $ / Total for non-Scouts
Total Amount Due: / $
PAYMENT INFORMATION

Method of Payment: [ ] Credit Card: [ ] M/C [ ] VISA [ ] AMEX [ ] DISC

Credit Card No.: ______Exp. Date: ______CVC Code: ______

Name of Card holder and Signature: ______