FLEXPASS V.I.P. Enrollment Form

I want to be a V.I.P!

I have enclosed a check for $195.00 and understand my membership
 is valid for up to one year from the date of sign up.

Reagle Players, 617 Lexington Street, Waltham, MA   02452

Date  ____________________________________

Name____________________________________________________________________________

Address__________________________________________________________________________

City________________________________  State__________________     Zip+4_______________

Telephone Number (Days) __________________________    (Evenings)__________________________