Nov 1-3, 2019 OXFORD JANIE'S JUMPSTART WEEKEND REGISTRATION FORM

JANIE'S JUMPSTART CAMP

Old Time Music Weekend

REGISTRATION AND PAYMENT FORM

November 1-3, 2019

For questions or more information contact: Jane Rothfield janerothfield@gmail.com

TUITION covers food, classes/jams, private instruction and house concert. Tuition does NOT cover accommodations

REGISTRATION, RATES, PAYMENT OPTIONS are outlined at the end of this form.

PLEASE FILL OUT THIS FORM COMPLETELY. ONCE WE GET YOUR REGISTRATION WE WILL CONTACT YOU DIRECTLY.

If you have any questions contact Janie at janerothfield@gmail.com or call 518-522-7445

YOUR NAME FOR OXFORD PA 11/1-3, 2019*

PLEASE INCLUDE YOUR FULL ADDRESS*

Best Phone # to reach you*

Email address*

Choose your class

Intermediate Clawhammer Banjo with Janie RothfieldAdvanced Clawhammer Banjo with Anna Roberts GevaltNovice Clawhammer Banjo with Gailanne AmundsenInt/Advanced Fiddle with Judy HymanIntermediate Guitar with Kellie AllenInt/Advanced Fiddle with Beverly Smith

Other instruments you play:

May we share your contact information (email) with other participants?

YesNo

What do you want to learn at Jumpstart?*

Are you taking music lessons now, or have you taken them in the past?*

If so, how would you rate your ability to learn by ear?*

How long have you been playing your instrument?*

Do you play and learn by ear?*

Have you been to other music camps?

Which ones?

JUMPSTART MEALS

High quality, freshly-prepared delicious food served family style-plus snacks, coffee and tea. Alcohol not provided (but not prohibited)

BYOB-Bring your own beverages of your choice.

MEALS OVERVIEW:

FULL WEEKEND includes all meals (Friday Dinner, Saturday Breakfast, lunch, dinner and Sunday Breakfast, and lunch PLUS coffee, tea and snacks).

Please indicate any food restrictions or allergies below.

Alcohol not provided (but not prohibited)

Dietary/Food Information-allergies, intollerances*

Food issue details here

Emergency Contact Information

Name :*

Phone number(s)*

Relationship*

ACCOMODATIONS

There are several Air BNB's and B&B's in the Oxford area and moderately priced chain hotels within 20-25 minutes of Oxford PA.

PAYMENT FOR JANIE’S JUMPSTART

Old Time Music Camp November 1-3, 2019

CAMP OPENS 4pm ON FRIDAY!

REGISTRATION INCLUDES MEALS/BEVERAGES, INSTRUCTION

and HOUSE CONCERT

IT DOES NOT INCLUDE HOUSING!

SPACE IS LIMITED!!

OPTIONS FOR PAYMENT THROUGH PAYPAL (janerothfield@gmail.com FRIENDS AND FAMILY) OR BY CHECK.

EARLY EARLY BIRD REGISTRATION (price available until June 1)

$375

Register and Pay IN FULL to reserve your spot.

EARLY BIRD REGISTRATION (available through September 1)

$400

Register with $100 deposit with balance of $300 due by Sept 1

REGULAR REGISTRATION: $425

Register with $100 Deposit and $325 balance due in full by Oct. 29)

REGISTRATION FEES ARE NON REFUNDABLE WITH THE EXCEPTION OF MEDICAL OR FAMILY EMERGENCIES. ARRANGEMENTS CAN BE MADE TO APPLY THE REGISTRATION FEE'S TO FUTURE JANIE'S JUMPSTART CAMPS OR SCHOLARSHIP.

PLEASE CHECK APPROPRIATE BOX BELOW FOR DEPOSIT, REGISTRATION TYPE, AND PAYMENT CHOICE

PAY BY CHECK OR PAYPAL (use janerothfield@gmail.com for paypal friends and family) REGISTRATION PAYMENT: Send check payable to Janie's Jumpstart Attn: Jane Rothfield 936 West Beverly Street, Staunton VA 24401

Deposit $100 (REQUIRED TO RESERVE YOUR SPOT) for Early Bird and Regular Registration onlyEarly Early Bird Registration PAY IN FULL (no deposit needed) until June 1 $375Early Bird Registration $300 (after $100 deposit) until Sept 1Regular Registration $325(after $100 deposit)

Thank you!

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