Jazz, Blues, Disco, Funk, R&B, Rock

Fan Club Registration

Name

Address

City State Zip

Home Phone Work Phone

Cell Phone

email  

Date of Birth

Number of Family Members

Favorite Party Night

Name of Company

Number of Company Employees 

Company Supervisor

Do you have a valid credit card? Yes No

Place you like to go

Things you like to do

Comments:

Weddings Private Parties Office Parties Company Picnics Conventions Grand Openings Cabarets Nightclubs
Reunions Retreats Craft Shows Festivals Sales Promotions Civic/Town Functions or Any Occasion

Email Us or Call 301-894-4215 for bookings or more information.

copyright 2009 by Curtis Johnson. all rights reserved.
web design by Synergistic Designs