Ticket Purchase Summary Sheet – Reserved Seating #____@$210

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Adv.Ticket Purchase
Order Form
Ticket Purchase Summary Sheet – Reserved Seating
Prices are in Canadian Dollars and include all applicable taxes. “Early Bird” Ticket prices apply only up to June 4, 2016.
Admission Tickets are non-refundable and cannot be exchanged. All ticket orders must be paid in full when placing order
SESSIONS
BEFORE June 4th.
All Session Pass (Preferred Seating)
AFTER June 4th.
Amount Due CKD
#____@$210 #____@$220
$________
#____@$ 55
Junior – Admission only
#____@$ 60
#____@$ 65
#____@$ 25 #____@$ 30
$_________
$_________
$_________
Session 3 & 4
#____@$ 65
#____@$ 70
#____@$ 65
#____@$ 30 #____@$ 35
#____@$ 65 #____@$ 70
#____@$135
#____@$ 30 #____@$ 35
$_________
$_________
$_________
$_________
$_________
$_________
*Limited Number
Session 1 & 2 - THURSDAY
*ADDITION - For Dinner
- FRIDAY
*ADDITION For Dinner
Junior – Admission only
Session 5 & 6
- SATURDAY
*ADDITION - Champagne Recptn. & Grand Banquet
Junior – Admission only
SUNDAY* (10:30am-12:30pm)
Lectures/Dance Workshops
$ 50
#____@$ 50
$_________
Souvenir Program
$ 25
#____@$ 25
$_________
#_________
_________
$_________
__x 3%_____
$_________
_________
$_________
TOTALS
T O T A L S – IF USING CREDIT CARD PLEASE ADD 3%
For your convenience, payment may be made in any form up until June 10th. After this date, payments need to be made by Certified
Cheque, Money Order, e-transfer or Credit Card. Personal / Studio Cheques will not be accepted after this date.
For Credit Card charges (Visa, MC), please fill out information below and add 3% Credit Card Surcharge.
Credit Card Charge Form – Canadian $ Only
Please Charge $___________to my VISA – MASTERCARD Expiration Date _____________Validation Code(3 digits)_______
Card #___________________________________________Name On Card_________________________________________
Your Billing Address_______________________________________________________Telephone #____________________
Signature ___________________________________________Email (for confirmation) ______________________________
MAIL or FAX TO: CAN-AM DANCESPORT GALA - 9 Lakeshore Rd. West
Oakville, ON Canada L6K 1C6
Tel: 416.605-8554 / 905.849-7323 Fax: 905.849-0702
2015
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