Ticket Form

"An Evening of Bluegrass"

THE FOX HUNT

Name:                                                                                                

Address:                                                                                            

City:                                                                                                      

State:           Zip:                              

Email:                                                                                                

# of tickets:            @ $12 each (Children under 13 FREE)

Total $:               Payable to "Smoked Country Jam" - No return on Purchases

Mail self-addresses stamped envelope along with payment to:
Smoked Country Jam, PO Box 175, Avis, PA 17721