Banjo Camp North - Registration Form
May 18, 19, & 20, 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
Minstrel/Classic
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).

Single room accomodations*, $625 (no discount). (Includes 6 meals).
Resident registration, $395. (Includes 6 meals) RV or camper, same as resident.
Commuter, $345. (Includes 6 meals). Staying where?
Deposit, $100. (Non-refundable.) Balance due by May 1st.
Non-playing spouse/partner, $275. (Includes 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, $200 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 March 15th. Some partial scholarships may be available.
*Single rooms are very limited -- there are only six such rooms available at the Pondside campus -- and must be paid in full, in advance.