REGISTRATION FORM - Fiddler's Dream Music & Dance Camp
Kingston, OK (Lake Texoma), Thu Dec 31, 2009 - Sun Jan 3, 2010
Name(s)________________________________________________________________
Name(s)________________________________________________________________
Street_________________________________________________________________
City_____________________________ State___ Zip_______ Ph# (___)___-____
E-mail___________________________________
Please do NOT list me in attendees directory. ___
Please provide the names and ages of all children registering with you.
_______________________________________________________________________
Dance, Music, or Other Session/Workshop: (what you'd like to OFFER
to lead OR what you'd like to see happen, and a suggested leader)
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Instrument(s) I will bring and play:
_______________________________________________________________________
I can play as a member of these Band(s):
_______________________________________________________________________

I'll volunteer to help:  set up (need 6 or so) ____   
refilling drink jugs ____   final clean up ____
running sound for 1 session ___   2 sessions ___

NO T-SHIRT THIS YEAR.

Accommodations: Put the # of campers in the appropriate blanks.
I prefer to stay off-site ______
Cabins: Women's: ______ Men's: ______ Couples: ______
Family(with kids): ______       I SNORE ____
I am single and would stay in a couples cabin ____ or family cabin ____
I want to stay in the same cabin as ___________________________________

                      Adult  Child 1-7
Cabin and Meals       $140 x ___    $70 x ___ = $___
RV/tent and Meals     $110 x ___    $55 x ___ = $___
Meals Only            $100 x ___    $50 x ___ = $___
Cabin Only            $100 x ___    $50 x ___ = $___
No Cabin or Meals     $100 x ___    $50 x ___ = $___
NTTDS Membership      $ 12/single, $18/family = $___
After Dec 20          $ 10 x ___              = $___

GRAND TOTAL: _______ people, $________

Make checks payable to: NTTDS and mail to
Mimi Rogers, 3415 Manana Dr., Dallas, TX, 75220
Contact: e-mail:  
or cell phone 214-403-2734
Use back, if necessary for any questions.
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