To reserve your space fill out this form and fax it to: (203) 431-0318 -or- mail to:
Dr. Don Teig
19 Ascot Way
Ridgefield, CT 06877
Fax forms are NOT sent over the world wide web, so that your
credit card information is not sent over an unsecured transmission. Full payment is due no later than December 11, 2010.
If you have any questions, don't hesitate to contact Dr. Don Teig
at contact@ultimateeventsllc.com