Dirty Line Dancing Credit Card Registration Page 
* * * each person MUST complete a separate registration form * * *
DDM Productions - Doug & Jackie Miranda
accept only Visa & Master Card credit cards
Please note that on your credit card statement the amount will show that it was charged to
"DDM Productions/Jacaranda Fashions". That is how our credit card machine is setup.
Please do not hesitate to contact us with any questions. A copy of your payment receipt
will be enclosed in your registration packet.
Payment Processing
Our new online shopping cart uses a SSL secured server. All transactions are processed through our Payment Gateway called Authorize.net. It is one of the most trusted names in the payments industry. If you click on the logo to the left you will be shown that our site is a verified user of Authorize.net.

PLEASE READ AND FOLLOW THESE INSTRUCTIONS!!
EACH PERSON MUST COMPLETE A REGISTRATION FORM
You must do 2 things in order to register and pay for this event:
You have to REGISTER AND You have to PURCHASE!
1) Fill out the registration form on this page and click on the "Register for Event" button at the BOTTOM of this page. This will send you to our Thank You page. On this page you can double check what you sent, then click on the link that says "click here to go back". Doing that will bring you right back here to this page so you can now make your Purchase.
2) Use the 'Buy Now' buttons to make your purchase using our secure shopping cart. Just click on the button next to the item(s) you wish to pay for. You will be taken to our shopping cart. If you wish to return here to this page before you make your final purchase, just click on 'Continue Shopping' which is at the bottom of the shopping cart.
Note: If you don't want to use our shopping cart, after you complete the registration form
you can call us on the telephone (951) 756-4451 and give us your credit card information.
Note: Completing the registration form is REQUIRED. It does not charge your credit card.
If you notice there is no place in the form asking for your credit card information. You have to
agree to the disclaimer which is in the form in order to register for the event.
Using this button will submit your registration form:
(This button only registers you, it does not make your purchase)
Using these buttons will take you to the shopping cart:
(These buttons are for purchases only, they do not register you)
THE BUTTONS ABOVE ARE JUST EXAMPLES, THEY DO NOT WORK!

E-mail: (required)
 Event:
Name: (required)
 Venue:
Street Address:
 Additional Address:
City:
 State/Prov:
 Zip/Postal:
Country:
 Phone:
 Verify E-mail:
Space for this event is limited! (only 200 Dancers)
ALL ROOMS MUST BE DOUBLE OCCUPANCY!
Dirty Line Dancing Weekend Available Passes
$425.00 per person
provides you with an all inclusive weekend (FRI, SAT, SUN) that includes your room, meals and all the workshops and entertainment you can handle from the mod quad and Joey Warren our special guest instructor!

$525.00 per person (includes Thursday Night arrival)
provides you with an all inclusive weekend (FRI, SAT, SUN) that includes your room, meals and all the workshops and entertainment you can handle from the mod quad and Joey Warren our special guest instructor!
THURSDAY EVENING ARRIVAL $100.00 per person
Additional Charge from Inclusive Weekend Package includes hotel accommodations, dinner, special movie showing and friday morning breakfast

Please choose an Event Pass
You may choose an Event Pass or pay your remaining balance
PLEASE NOTE THAT THERE ARE NO REFUNDS FOR THIS EVENT
Weekend Pass (Fri-Sun) $425.00 per person  
Weekend Pass + Thursday $525.00 per person  

Weekend Pass (Fri-Sun) Balance $210.00 per person  
Weekend Pass + Thursday Balance $310.00 per person  

Paying for Roommates or Guests
(Each person MUST fill out a separate registration form)
* * VERY IMPORTANT: You may pay for more than one person, or someone may pay for you. However each person attending must fill out a separate registration form. If you answered 'YES' to one of the 2 questions below, please enter the names in the box below so that Doug & Jackie know who belongs together.
* If you answered 'NO' to both questions then go right to the Disclaimer part!
* If you are paying for someone, you should answer 'YES' to the first question and 'NO' to the second question. Please enter that person's name in the box below. Please fill in the Disclaimer box, and then select a payment method!
* If someone is paying for you, you should answer 'NO' to the first question and 'YES' to the second question. Please enter that person's name in the box below. Please fill in the Disclaimer box, and then skip the payment selection!
Are you paying for more than one person?   Yes   No
Is someone paying for you?   Yes   No
Please list your roommates or guests' names: (please specify who they are)

Disclaimer Agreement
* * VERY IMPORTANT: You must read & agree to this Disclaimer in order to register
I agree to hold organizers of Dirty Line Dancing Weekend and their agents harmless from suits, claims and demands of every kind and character arising out of and in conjunction with this event. We hereby assign all rights to Video taping and sound recording of us on September 11th thru 14th 2008, and hereby authorize the reproduction, sales, copyright exhibition, broadcast and distribution of those videotapes without limitation. I acknowledge there are NO REFUNDS OF ANY KIND for this event.
Do you agree to the terms of the disclaimer?  
You must type in Yes I Agree in the box above for the form to process!  

Please Select Your Payment Method
On this page you have 2 options of making your purchase by credit card. You can use our new secure online shopping cart or you can call us on the telephone (951) 756-4451 after you submit your registration form
Use our secure Shopping Cart Call us on the Telephone

          

* * Important Note:  Clicking on the "Register for Event" button sends an e-mail to
Doug & Jackie at this e-mail address: modquad@djdancing.com. It also activates
the "Thank You" page. If that does not happen, contact Doug & Jackie ASAP
The e-mail that is created and sent by this form goes to E-mails Servers that are
H.I.P.A. (Health Information Protection Act) compliant. H.I.P.A. requirements insist
that there be a 128 bit encryption in all e-mails coming and going from the servers.

• DDM Productions •
535 Maggie Mack Lane, Sevierville, TN 37862
Phone: (951) 756-4451 Fax: (865) 774-3333
E-mail: BonanzaB@aol.com
For questions contact Doug or Jackie day or evening!