Boots & Bling

Ladies Round up your Buck-a-Roo for a Date Night
April 25, 2020
Concordia Armory
Doors Open at 6:00 p.m.
Dinner Served at 6:30 p.m.
Dancing from 7:00 p.m. to 8:00 p.m.
Boot & Bling: $30
Additional Boot(s): $5
Reserved Table for 6: Additional $25

Name of Bling (Mother, Grandmother, Aunt, etc.) First Last
Name of Boot (Son, Grandson, Nephew, Young Man, etc.) First Last
List Additional Boot(s) Attending
Email Address
Mailing Address
Street Address
City State Zip
Phone Number (###) ### ####
Meal choices.
Brisket, Au Gratin Potatoes, and Corn
Hot Dog, Chips, and a Fruit Cup
Boot & Bling - $30
Additional Boots - $5
Reserved Table for 6 - Add $25

Item	Amount
Boot and Bling
Additional Boots
Reserved Table for 6
Total Amount

Payment Preference Pay online. Mail payment to: NCKDSS, C/O Shella Thoman, 616 E 13th St, Concordia, KS 66901
Waiver. In consideration of me and/or my minor child(ren) being permitted to participate in this event, I hereby for myself, my heirs and personal representatives assume any and all risks which might be associated with the event. I further waive, release, discharge and covenant not to sue the Down Syndrome Society, its officers, employees, sponsors, organizers, volunteers or other representatives or their successors and assigns, for any and all injuries or damages of any kind whatsoever suffered by myself and/or my minor child(ren) as a result of taking part in the event and any related activities. I also authorize the use by NCKDSS of any photo, film or video tape taken of me or my minor child(ren) at the event for any purpose. I agree to the waiver.
Please list any comments or notes. Thank you.