[tubaman]

Print the registration and mail it with a check of $25.00 per person to:
Lin Ferrarese
8714 Serene Ridge Drive
San Antonio, Tx 78239

Checks, money orders and cash are fine; I don't have Pay Pal.







TEXAS ALL-STATE SPANKING PARTY REGISTRATION FORM

Name (Last, First) _________________________________________

Street address or dependable email address (Make SURE this is right.
Your party information will be sent this way. You can supply both if you wish.)

__________________________________________________ ___

__________________________________________________ ___

Emergency contact: (name) ____________________________________

Emergency contact phone: __________________________________________

Speakeasy Name: (For name tag) choose an adjective and your name, like Blowsy Katherine or Lazy Boy Jake


__________________________________________________ _________________


Circle one: Top / Bottom / Switch / Observer
Circle one: Male Female

Birthdate: ______________________

Check any that apply:

_____ I am a vendor and would like to be part of the vendor fair.

_____ I am a single lady and would like to stay in one of
the "sorority rooms."

_____ I am new and would like a "mentor.”

ALL OF THE ABOVE INFORMATION, WITH THE EXCEPTION OF
THE INFORMATION ON YOUR NAME TAG, WILL BE KEPT STRICTLY
CONFIDENTIAL. IF YOU ARE A MARRIED COUPLE, YOU MAY SIMPLY STATE THE
NAME OF YOUR SPOUSE AS YOUR EMERGENCY CONTACT, IF HE/SHE
WILL BE AT THE PARTY ANYWAY.

My signature below certifies that I have read the party rules and
agree to abide by them. I will hold the All-State Party organizers
harmless for any injuries or accidents to my person, regardless of
the cause of same, including, but not limited to any injury or
accident caused solely by the negligence of the organizers. I will
hold the organizers harmless for any lost or stolen items of personal
property that belong to me. I will be responsible for any accidents,
injuries, or damages to any persons or property caused by myself or
my actions. I certify that I will not be under the influence of any
illicit or mind-altering drugs at the party.

__________________________________________________ ____ ____________