_______________________________ _________________ __________________ (______)_______________ Print: Name His Hers Phone ___________________________________________ __________________ __________ ___________ Street Address City State Zip Council Area_____________________________ Caller(____) Cuer(______) Solo (____) Council Area__________________________ Solo (____) Caller (____) Cuer (____) PRE-REGISTRATION OPTIONS: ADULT YOUTH (17 & under) TOTAL Full Package (Fri. & Sat.) #_____@$25.00 #_____@$12.00 $_______ Friday Night Only #_____@$14.00 #_____@$ 7.00 $_______ Saturday All Day #_____@$22.00 #_____@$10.00 $_______ Saturday Night Only #_____@$14.00 #_____@$ 7.00 $_______ ALL PRICES PER PERSON—PRICES HIGHER AT THE DOOR RV PARKING NO HOOKUPS AVAILABLE RV Length _________ Slide Yes(__) No (__) Do you have a Generator? Yes(__) No (__) Friday and Saturday Night #_________@$20.00 per space $________ Friday Night Only #_________@$10.00 per space $________ Saturday Night Only #_________@$10.00 per space $________ Register together—Arrive together– Camp together PRE-REGISTRATION AND CANCELLATION DEADLINE IS MAY 20, 2001 Cancellation Fee $5.00 MAKE CHECK PAYABLE TO: KALEIDOSCOPE 2001 MAIL CHECKS TO: SAM & LINDA MARGHEIM 1575 BARRES STREET STRASBURG, CO 80136 TOTAL AMOUNT ENCLOSED: $________ APPROPRIATE DANCE ATTIRE IS SUGGESTED AT ALL ACTIVITIES DANCE LEVELS—PLEASE CHECK ALL THAT APPLY Mainstream (_____) ROUNDS Basic (_____) Plus (_____) Intermediate (_____) Advanced (_____) Advanced (_____)