Here is my full payment of $_________ for the November 2-4, 2012 Eisteddfod. (All rooms have private bath.)
adults, double; _____members @ $340 ea, _____non-members @ $355 ea=$________
____children (13-17, sharing with 2 adults), age_____, @ $125 ea= $________.
____children (6-12, sharing with 2 adults), age_____, @ $85 ea= $________.
____children (5 and under, sharing with 2 adults), age_____, free.
adults, triple, _____members @ $295 ea; _____non-members @ $310 ea=$________
adults, single, _____ members @ $440 ea; _____non-members @ $455 ea=$________
____Students (full-time) 17-22, in double room @ $265 ea = $_______
Special "Friends" rate (groups of 3 or more age 21-35, registering as a group): _____ triple rooms @ $150 ea; ____ double rooms @ $180 ea = $________
[ ] I wish to help support the Eisteddfod; my check includes an additional $_________. (Additional contributions are tax deductible, as permitted by law.)
Name___________________________________ Phone day (____ )________________;
Address__________________________________, eve (____)_____________________
City___________________________ State _____ ZIP ________________
E-Mail: ___________________________________
Emergency contact during weekend:________________________________
Other Names in Party:____________________________________________________________________
Requested room or roommate?_____________________________________
[ ] vegetarian; [ ] vegetarian eats fish; [ ] vegan; [ ] no red meat; [ ] no poultry; [ ] no fish; [ ] no dairy; [ ]other(explain:____________________________________________)
[ ] I will be driving from ____________________________________ at _____AM/PM and can take ___ additional passengers.
[ ] I need a ride, from ______________________________________________________, if possible
Do not include my [ ]e-mail and/or [ ]phone number on the address list..
*organizations include: Borderline Folk Music Club; Branford Folk Music Soc.; Country Dance and Song Soc. (CDSS); Folk Project, NJ; Folk Song Soc. of Greater Boston; Folklore Soc. of Greater Washington; New York Revels; & Peoples' Music Network. Please indicate which organization you are a member of.
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