Final Payment Form

Welcome to

The Bobby Darin Lifetime Events 2007

FINAL PAYMENT FORM

BOBBY DARIN IS BACK IN VEGAS !!!

For Further information contact:

Vicki Shonerd at cameraguy2006@cox.net or penguingirl50@cox.net

Please make your checks payable as follows:

Vicki Shonerd/Darin Lifetime Events 07

Your Name: ___________________________________________

No. in Party: ____________________

Total Amount submitted: $________________________

Emergency Contact Information: In case of an emergency and you are incapacitated, who do we contact??

Name: __________________________________________

Home Telephone: _________________________________

Cell phone: _________________________________________

A roster of attendees and guests will be prepared and provided by the end of the Darin Lifetime Event 07.

By signing below, you consent to allowing your name to be included

in this roster and acknowledgement that you may be included

in filming and/or photography taken during the event.

Signature:__________________________

Date: ______________________

For information: CameraGuy2006@cox.net

Bobby Darin Forever!!