Printable Form

P O Box 610314
DFW Airport, TX 75261

How will I know if my reservation is accepted?
Staff  will notify you by email  as soon as schedule is complete, usually 2 days before the event. 

What if an event for my age range is full?
You will be notified of this fact and you will be put on a waiting list.  Or, if you choose,  your payment will be refunded. 

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You MUST have a reservation and pay in advance. There is no walk-up attendance. And, yes, proof of identity and age is required at door.

I am making paid & guaranteed reservation for  Sunday, April 30,  2006

My Date of Birth: ____/ ____/ ____     Today's date: ____/ ____/ ____ 

Please give 12 year age range you prefer to date. Age range must include your own age. Example: You are 36 years old. You prefer to date singles ages 30-42. Type "Age 30 to 42" Age ____ to ____

Email Address : ________________________________________
Most correspondence is by email. Please print so we can read it.

Day Phone:  (__________) ___________________________
Week-end Phone:  (__________) ______________________
___ Male   ___ Female

Payment by Check/Money Order Payable to SINGLES:
Must be postmarked by Apr 24, 2005

Check number: ________________ 
Amount Paid: $______________ 
     Pay $34 each.

By registering for this event, you hereby release and hold Heart Express and SOLO for Singles, their owners, agents, and employees harmless from any and all claims and damages, whether it be caused by myself, by any other person, or by the ordinary negligence of Heart Express, SOLO for Singles,  their owners, agents, or employees. 

Signed ______________________
Please print:
Name: ___________________________________________

Address:  ________________________________________ 

Suite/Apt ____________

City: _______________________ State _____  Zip_______

Print, fill out and mail form with check. Make check payable to Singles and mail to Singles, P O Box 610314, DFW Airport, TX 75261.