Before filling out this registration form, please read the information on the page devoted to Django Camp Registration. Print and fill out a separate registration form for each person attending. If you are only pre-registering at this point, just fill out the necessary items in the top table and enclose a check for $200. If you are fully registering, choose one item from categories A, B and C and add 'em up to get your total. Then fill in the info at the bottom and send it our way.
Please make checks payable to Andrew Lawrence . The address is PO Box 507, Williamsburg, MA 01096. Thanks!
| The Pre-Registration fee is $200. The balance is due one month before the event, May 10th. |
| Your Instrument: |
| Will you need a room on campus? |
| Would you like the campus meal plan? |
| If you are in a position to contribute to our financial aid fund, please do. Thanks! Amount enclosed: |
Category |
Options |
Add up your selections. |
Tuition & Concerts |
Musicians – $350 | $ |
| Non-musicians – $100 | ||
Housing & Facilities |
On-site Housing and Facilities – $350 | $ |
Facility Fee Only (No Housing) – $150 |
||
Food |
All meals – $190 | $ |
Health Insurance |
If you do not have health insurance, we are required to purchase it for you while you're here. If you need it, please pay 50% of the cost here ($9) and we'll cover the other half for you. | $ |
Financial Aid Fund |
If you are in a position to contribute to our financial aid fund, please do. Thanks! | $ |
| Total | $ | |
Name:
Mailing Address:
Email:
Phone(s):
Gender (for housing assignments):
What instrument do you play?
If you signed up for the meal plan, do you have any special dietary needs?
Emergency contact during Django Camp:
On the back, please tell us a little about your experience with this music and your particular interests.