Dirty Line Dancing PayPal 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.

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!  

PayPal Registration & Payment Section
You must do 2 things in order to register and pay for this event:
1) Enter your total & click on the "Register for Event" button below. This will send you
to our Thank You page. 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.
2) You must return to this page and then click on the "PayPal" button. This will take
you to the PayPal page. The event name will be entered for you already, you just have
to enter your total. Then log-in to PayPal and make your payment to our PayPal account.
When finished, just use the back button on your browser to return to our site.
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.
You may also pay with a Credit Card on the PayPal page. There is a whole section
for using your credit card. You must still add the PayPal fee to your total. PayPal is
the one doing the processing so the fee will still be charged to DDM Productions.
Payment Method:  Please enter your Total here: 

          

Submit your registration, then return here to make
your PayPal payment by clicking on this button:
Please add $1.00 for every $25.00 to your final total payment!

$1-$25 add $1, $26-$50 add $2, $51-$75 add $3, $76-$100 add $4, etc...

* * Important Notation: PayPal charges a fee for every transaction.**
It changes depending on the amount of the transaction. We believe
we have come up with a fair amount to cover this transaction fee.
Thank you for your cooperation in helping us deal with this matter

* * 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

• 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!