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Please fill out the following 10 Questions
to Request-A-Song for an upcoming event.

Your 1st & Last Name?

Your Phone Number

Your Email Address?

Date of the Event?

Who is the Guest(s) Of Honor?

Your Song Request(s)?

Which of the following activities do you LIKE?
(Include As Many As You Want)
     •Electric Slide
     •Macarena
     •Twist
     •YMCA
     •Conga Line
     •Cha-Cha Slide
     •Greased Lightning
     •Chicken Dance
     •Stroll
     •Limbo
     •Shout
     •Polka
     •Waltz
     •Tarantella
     •Cha-Cha (Not The Slide)
     •Sweet Caroline (Sing-A-Long)
     •Swing Dance
     •Country Line Dancing
     •American Pie (Sing-A-Long)
     •Piano Man (Sing-A-Long)
     •Other Dances or Activities

Which of the above Activities do you NOT like?

Announcement for us to make? (Birthdays,Anniversaries...)

Fun Facts about Guest(s) Of Honor?

Other Comments