Samantha's Place Event Registration
You must complete ALL sections of this page. Click "Submit" when ready to send.

or	We would like to RSVP for the next Samantha's Place Club Night!  We would like to RSVP for the next Swinger's Speed Dating Event!  nnn
Her first name:
His first name:
Phone:	To be used only in emergency to contact you with any last minute change of location or details We will be discreet.....and only speak with you directly.
Email address:	We will send your confirmation details and directions to this address. Please also check your junk mail or spam filter within 48 hours if you have not received your confirmation and directions. Please ensure the address is correct OR you can not receive a confirmation and directions to our club

We are a:
Couple   or  Single Female
This is our first time at Samantha's Place.
 

Please add us to the guest list for the NEXT Samantha's Place Club Night as:
We are Samantha's Place Members. ($25.00 per couple)
      Be sure and bring your Samantha's Place Membership Card with you to show at the door
We are coming as Samantha's Place Guests for now. ($40.00 per couple)

We would like to become Samantha's Place Members. ($60.00 per year)
      Pay for your yearly membership at the door and get in for the members rate of just $25.00 starting at that event 

Any additional comments or questions?

When you hit "Submit" it will take you to a separate (white) ad page with a progress bar at the top.
Once your RSVP form is finished submitting, click the "continue" link next to the progress bar to return to this website.