EmailMe Form - UnCorked SKETCH and SIP RSVP Form

Name *

First Last

Phone Number *

### - ### - ####

Email *

Semi Nude Live Model

Andrew K. Currey

Choose the reservation date *

Sat, May 9th, 6:30pm-9pm

Deadline to RSVP is Friday, May 1st.

Number of spaces you want to RSVP *

Provide sourcecode# or referral name here, if you have one. Sorry Voucher#'s are not eligible for this event.

please dbl check code#. Separate multiples with commas.

What are you musical preferences? (Michael Jackson, Bon Jovi, Beyonce, Beatles, World music, Latin/African ect.)

We will do our best to accomodate various musical tastes.

Please provide the names of your guests. Or, if you are part of a bigger party, list the name of the HOST.

First names separated with commas.

Private Party

Yes! I would like to reserve the studio for a private party

Private party requires a minimum of 15 people and is subject to availability. The cost details will be handled separately after we recieve RSVP form.

PAYMENT

Once payment has been processed, the Studio Manager will send you an email to confirm your space. If you need to cancel, you have 48hours prior to the event start time cancel and get full refund. See your confirmation with cancellation details in it. Within 48hours refunds are not guaranteed. Refunds are not given for no-shows.

Payment are made to State of Mind Media LLC

Type of card *

MC

Visa

CC # (please bring card with you to studio for security check) *

Your information is encrypted for safe passage.

Card Expiration Date *

MM / YY

Billing Zip Code *

EVENT LOCATION & WEBSITE

Urban Wellness Creative Studio
5372 W. Pico Blvd.
Los Angeles, CA 90019
323.908.3455
www.PaintandSipLosAngeles.com