Singles Registration Form – Black Hills Mini Shindig

Contact Information

How did you hear about the Shindig?

Name *

Age *

Gender *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Phone *

Cell Phone

Email Address *

Registration Type

Registration Type *

Meal Selections

Meals Selection *No MealsAll MealsSome Meals

Do you require gluten free meals? *YesNo

Housing

Number of Nights

Select Housing *

RV Hookup *

RV Electric *

RV Length *

If you need handicap accessibility or other considerations please note that here or call us at (307) 388-0933. (Please type N/A if you do not need any considerations.)

Total $ Due

Non-Refundable Shindig Registration Fee

$

Meals

$

Shirt(s)

$

Housing

$

Total Due

$