Print this attendance form, fill in and send in with your
payment, payable to:
YALLAH DANCE, INC.
282 Magnolia Avenue
Unit# 6
Jersey City, NJ 07306
(Please print. All info will be kept confidential)
First Name: _____________________________________
Last Name: _____________________________________
Email: _______________________________________________
Mailing address:
Street: _______________________________________ Apt.# _________
City: ___________________________ State: ______ Zip:___________
Phone: ________________________ (emergency purposes only)
Event:
SEPT 21,
2003 - Yallah Dance Anniversary Party!
Cost:
$43.00 per person payable prior to event.
No Walk-ins.
No Refunds. No Minors, due to open bar.
Amount of payment enclosed: __________
Number of attendees in your party: __________
Kindly specify the other names in your group below:
_______________________________ , _______________________________
_______________________________ , _______________________________
_______________________________ , _______________________________
(Just like with any strenuous physical activity, consult your doctor 1st before engaging in such.)