• Make checks payable to: Charleston Shag Club
  
• Mail to: Charleston Shag Club, 603 Wading Court, Mt. Pleasant, S.C. 29464
  

NAME: ________________________________________________________________________________________________

STREET ADDRESS:______________________________________________________________________________________

CITY:_________________________________________  STATE____________________________  ZIP  ________________

PHONE: (H)__________________ (W):___________________  (C):___________________   BIRTHDAY :(M)____  (D)____

EMAIL  ADDR:__________________________________________  PROFESSION:__________________________________       

The purpose of this club is to preserve, encourage and promote the education of the Shag and to provide  activities at which emphasis is placed  on the dance. The Charleston  Shag Club encourages all members to support the club by  serving on committees carrying out "fun work".  Please indicate your choice of  committee participation.

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