ANGOLA PRISON RODEO - TICKET ORDER FORM

Shipping Address:

Name:   _{___________________________________________}

Street/State/ZIP:   ____________________________________________________________________________

Phone:  (_____) ______ - __________ (Home)     (_____) ______ - __________ (Work)

_{MAIL (if time allows)  __________  or HOLD AT "WILL CALL" BOOTH  __________}

_{NOTE:  A child 2 years old or under is admitted free if they are held by an adult.}

NOTE:  No Personal checks allowed.

_{Make Cashier's Check or Money Order payable to ANGOLA PRISON RODEO, or charge to a Visa, MasterCard, American Express or Discover Card by completing the following information:}

Billing Name and Address - If different from above:  (NOTE:  This name and address must match the credit card billing name and address.)

Name:    _____________________________________

Street/State/Zip:  __________________________________________________________________________

Credit Card No. _______________________________        Expiration Date:  ______________

Last three digits on the right, on back of credit card:  _____________ (Required for processing)

Signature:  ____________________________________  (Person whose name appears on the card)

Comments:

Mail FORM and PAYMENT, IF APPLICABLE to:

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