Staunton March 8-10, 2019 JANIE'S JUMPSTART WEEKEND REGISTRATION FORM

JANIE'S JUMPSTART CAMP

Austin, TX

Old Time Music Weekend

REGISTRATION AND PAYMENT FORM

Jan 31-Feb 2, 2020

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 AUSTIN TX CAMP *

PLEASE INCLUDE YOUR FULL ADDRESS *

Best Phone # to reach you *

Email address *

Choose your class

Int Guitar/Old Time Songs (Kellie Allen) Int/Adv Old Time Fiddle (Janie Rothfield) Int Clawhammer and Fingerstyle Banjo (Pete Peterson)

Other instruments you play:

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

Yes No

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 many options for accomodations in Austin TEXAS-hotels and air BNB's.

PAYMENT FOR JANIE’S JUMPSTART

Austin Texas

Old Time Music Weekend

January 31-February 2, 2020

CAMP OPENS 4pm ON FRIDAY!

REGISTRATION INCLUDES MEALS/BEVERAGES, INSTRUCTION

and HOUSE CONCERT

IT DOES NOT INCLUDE HOUSING!

SPACE IS LIMITED TO 8 STUDENTS PER CLASS!!

OPTIONS FOR PAYMENT THROUGH PAYPAL USING FRIENDS AND FAMILY TO AVOID FEES!! (janerothfield@gmail.com) OR BY CHECK.

EARLY EARLY BIRD REGISTRATION (price available until Dec 15, 2019)

$325

EARLY BIRD REGISTRATION (available through Dec 31, 2019)

$375

REGULAR REGISTRATION

$400

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

FOR REGISTRATION PAYMENT PAY BY PAYPAL (use janerothfield@gmail.com for paypal) USE FRIENDS AND FAMILY TO AVOID FEES!! OR CHECK:Send check payable to Janie's Jumpstart Attn: Jane Rothfield 936 West Beverly Street, Staunton VA 24401

Early Early Bird Registration Available until Dec 15 $325 Early Bird Registration Available until 12/31/2019 $375 Regular Registration (after 12/31) $400

Thank you!