-=[ AMERICAN BANJO CAMP 2012 REGISTRATION ]=-

 NAME:                               TODAY'S DATE:   /  /
 STREET ADDRESS:                               
 CITY,STATE,ZIP:                     PHONE:
 EMAIL:                              AGE:
 ABC T-SHIRT SIZE (not available after 8/15):
  $15 up to XL, $17 for XXL and up; +$3 for long-sleeve.

 I expect to attend classes mostly in:     __ No classes ("spouse")
  __ BG Banjo     __ OT Banjo     __ Fiddle     __ Guitar

 SKILL LEVEL, check whatever comes closest:
 a __ RANK BEGINNER (I just got my instrument.)
 b __ BEGINNER (up to 6 months playing.)
 c __ LOW INT. (6-24 months; still need a lot of technical help)
 d __ HIGH INT. (two or more years; play well at a basic level)
 e __ ADV (many years; can play up to speed.)
 f __ PRO (play in working bands.)

 JAM PREFERENCES, check all that apply:
 a __ I've never (or hardly ever) jammed before; get me started!
 b __ I've jammed some, but need slow tempos & straight tunes.
 c __ I'd like to have someone call out the chord changes.
 d __ I'd enjoy a moderate jam (familiar tunes, medium tempos).
 e __ I'd enjoy an up-to-speed jam (standard tunes, any speed).
 f __ I'd enjoy a wild, experts' jam (no holds barred).
 g __ I'd enjoy watching a wild, no-holds-barred, experts' jam.

 INTEREST AREAS, check all that apply:
 BG Banjo:  a__Basic  b__Straight Scruggs  c__Chromatic  d__Melodic
 OT Banjo:  e__Basic  f__Round Peak  g__Melodic  i__Song accomp.
 j__Older fingerpicking k__Roots Artist Styles l__Repertoire(tunes)
 h__Fiddle   n__Guitar   m__Other (describe)______________________

 If we hire more teachers, whom would you like to see added?

 How did you hear about American Banjo Camp?

 PICK   (Basic camp)  __$440 Fri-Sun  __$220 spouse rate Fri-Sun
  ONE    (Extra Day)  __$566 Thu-Sun  __$330 spouse rate Thu-Sun

 I'm paying by:  __Check/Money Order    __Visa    __Mastercard
 Credit card number:                        Exp:     /
 Billing addr (if different):
 __I'm paying just a $100 deposit today (OK until July)

 Lodging     women:  __ Women-only  __ Co-ed okay  __ tent/RV/other
 (PICK ONE)    men:  __ Men-only    __ Co-ed okay  __ tent/RV/other

 Put me in:  __ the action!  __ a quiet area  __ a VERY quiet area

 Emergency Contact (name, relationship, phone)?

 Dietary or physical issues we should know about?