Banjo Camp North Fall Edition - Registration Form
September 7, 8, & 9, 2012
Fill in the form on-screen, then choose "File - Print" and mail it in with payment to:
Banjo Camp North, PO Box 1755, Orleans, MA 02653
Attendees younger than 18 must be accompanied by a parent.
If registering for more than one person, please submit a separate form for each individual.
(Returnees -- you may fill in just your name and any information that has changed.)

First Name:	Last Name:	Date:
Address:
City:	State:	Zip:
Country:	Phone:	Cell Phone:
Email:	Name on badge:	Returnee?

Playing Level: Novice: cannot play at all, or just a little, but not with others. Beginner: play some tunes, basic chords, & chord changes. Intermediate: play tunes, recognize changes, play with others slowly. Advanced: play tunes up-to-speed, want to improve playing in groups.	Main Interest? Bluegrass Old Time Mandolin Track Other interests? Fiddle Guitar
Special: Vegetarian Women's cabin Quiet cabin 10pm-8am Single room* Special needs
Where did you hear about BCN? Free T-shirt size? (S-4x)
Payment Options Notice! You must bring your own blanket & linens, or sleeping bag plus pillow and towel. Rooms have bunk beds. If you can't get into an upper bunk, indicate in the Special Needs box above. Tuition, room, & board in full: (12:30 PM Friday - 3:00 PM Sunday, 6 meals). Early-bird registration Pay in full before June 15^th and save! Single room accomodations, $650 (no discount). (Includes 6 meals). Early Bird Resident, pay only $395. ($425 thereafter) (Includes 6 meals) RV or camper, same as resident. Early Bird Commuter, pay only $345. ($395 thereafter) Staying where? Deposit, $100. (Non-refundable.) Balance due by June 15^th to qualify for Early discount. Non-playing spouse/partner, $250. (Noon Friday - 4PM Sunday, 6 meals). Day rates:* Thursday evening, $75 includes room & bed only -- no food -- for early arrivees. Friday only, $200 includes supper but no accommodations. Saturday only, $300 includes 3 meals but no accommodations. Sunday only, $250 includes breakfast & lunch but no accommodations.
Total amount: Payment type: Check enclosed Mastercard Visa Discover Name as it appears on credit card: Credit card number: - - - Exp. Date The first $100 of the registration is a processing fee and is not refundable. No refunds after July 15^th. Some partial scholarships may be available. Single rooms are limited; there are six such rooms at the Pondside campus, five at the Hilltop campus. They must be paid in full, in advance.