NEW:

Registration form online: www.hernandocounty.us/parks_rec OR purchase tickets at HCRD:

16161 Flight Path Drive 352-754-4031 Like us on Facebook!

Hernando County Parks & Recreation presents

Dancing, Music, Snacks, Drinks. Photo Booth Fun

Sponsors:

Father Daughter Dance

visit website for classes we offer, adult sports, buildings to rent...

www.hernandocounty.us/parks_rec

Weeki Wachee High School

12150 Vespa Way Weeki Wachee

NEW LOCATION

Friday, Feb 5 - 7pm - 10 pm Saturday, Feb 6 - 6pm - 9pm

Advance Ticket Sales Only Tickets go on sale January 5 $15 per person All ages welcome, babies, teens, adult daughters

Come with dad, step dad, grandpa, uncle...

f:\recreation\forms\f d d reg forms\fdd reg form 2016.docx

DEPARTMENT OF PARKS AND RECREATION FATHER DAUGHTER

1 6 1 6 1 F L I G H T P A T H D R I V E B R O O K S V I L L E , F L O R I D A 3 4 6 0 4 w w w . H e r n a n d o C o u n t y . u s

R E C R E AT I O N P 3 5 2 . 7 5 4 . 4 0 3 1 F 3 5 2 . 7 5 4 . 4 4 1 5 P AR K S P 3 5 2 . 7 5 4 . 4 0 2 7 F 3 5 2 . 7 5 4 . 4 4 2 7

Father Daughter Dance Ticket Appl icat ion

________________________________________________________________________________________________________ LAST NAME FIRST NAME MIDDLE INITIAL MAIN CONTACT PHONE

______________________________________________________________________ ADDRESS CITY ZIP

______________________________________________________________________ WORK PHONE CELL PHONE EMAIL ADDRESS

______________________________________________________________________ PERSON TO NOTIFY IN CASE OF EMERGENCY MAIN PHONE ALTERNATE PHONE

***Please note the Father Daughter Dance is a public event and members of the media will be

on site to cover this event. I understand by registering for the event I’m subject to photographs

and videos that may be taken and used for print and/or electronic media for publication and

future promotion of the event for the department ***

****NEW LOCATION**** ***WEEKI WACHEE HIGH SCHOOL- 12150 Vespa Way,

Weeki Wachee, Fl 34614 ***

[ ] Father Daughter Dance --- FRIDAY # of tickets_____________

[ ] Father Daughter Dance --- SATURDAY # of tickets_____________

TICKETS -$15 PER PERSON – Plus .50cents extra for tickets being mailed.

SIGNATURE OF APPLICANT: ________________________________________ DATE:__________________________

PRINT NAME:_____________________________________________________ FEES DUE: $____________________

Payment accepted: Check, Cash, Money Orders, VISA, MasterCard or Discover.Payable to: HCRD or Hernando County Recreation Department.

Received by STAFF: ________ Mail: ______ Fax: ______ Walk In: ______ App Entered By: ______________

Fees Due: $ _____________ Payment Received By: Entered By: ___________

PAYMENT TYPE: [ ] MONEY ORDER / [ ] CHECK #________________ Credit Card Payment by [ ] Phone / [ ] Walk In

[ ] VISA or [ ] MASTERCARD [ ] DISCOVER ~ APPROVAL # ________________

OFFICE USE ONLY