Generation X

Date:
Name:
Address:
Apt. no.:
City:
State/Country:
Zip Code:
Contact Phone:
E-Mail:
Section:
Male:
Female:

Men: shorts size:
	M
	L
	XL

Premium Package $ 45.00

Ladies: One and two piece bathingsuits are available with underwire (no additional charge).

Please indicate swimsuit preference:
1 piece:	S	2 piece:	S
	M		M
	L		L
	XL		XL

All orders are subject to availability.

When your order is processed you will be notified if your selected size is available.

Please submit this completed form and send check for non-refundable $50 deposit to:
Generation X
12100 SW 112th Avenue, Miami, Florida 33176

Please make all checks out to Generation X.
Make sure your name or the name of the person ordering
appears somewhere on the check.

Costume will not be guaranteed until payment is received. We will acknowledge receipt by E-mail.

Final payment for costumes will be accepted in CASH ONLY.

Thank you,
Generation X