WORLD MUSIC AND DANCE CAMP,
OCTOBER 5- 8, 2001/ CAPE COD,
MA
REGISTRATION FORM - Print, fill out and mail to address below
Name(s):_____________________________________________
Address:_____________________________________________
City, State, Zip:____________________________________
Country:_____________________________________________
Phone:_______________________________________________
Email:_______________________________________________
Accomodations - check one:
Men's Cabin:_____________
Women's Cabin:___________
Coed:____________________
If you wish to be housed with someone, list all names.
ALL persons must indicate preferences here:
_________________________________________________________________
Food Preference
No Restrictions:_______ Vegetarian:_______
Other (please explain):__________________________________________
Music Consulting
I am interested in consulting on the following instrument(s)
_________________________________________________________________
Registration Fees Enclosed (please complete):
Adult-Entire Weekend--------#___persons @ $315.00 each_______
Adult-No accommodations-----#___persons @ $260.00 each_______
Youth (ages 8 through 24)---#___persons @ $157.00 each_______
Children (ages 0 through 7)-#___persons @ FREE -------___0___
Early registration discount-#___persons @ <$25.00 ea> _______
Late Fee (after Sept. 28)---#___persons @ $ 20.00 each_______
TOTAL ENCLOSED----------------------------------------_______
Waiver of Responsibility
World Music and Dance Camp does not cover bodily injury to any person participating
in dance or other activities which we sponsor or which are conducted on premises
we rent or use. Your registration signifies acceptance of the above statement
and that you personally assume responsibility for any medical costs incurred.
Please mail this form with payment in U.S. funds to:
World Music & Dance Camp
c/o Ahmet Lüleci
17 Bartlett Crescent
Brookline, MA 02446
For more info, our website is www.geocities.com/worldcamp
or call or fax us at: 617-232-4140. You can also email us at:
Ahmet@rcn.com or worldcamp@yahoo.com