| SSAMC REGISTRATION FORM |
| Date: _________________ |
| Name (Last): _____________________________ (First): ___________________________ |
| Address (Street): ___________________________________________________________ |
| Address (City): __________________________________(State):______(ZIP):__________ |
| Telephone: __________________________ E-mail: _______________________________ |
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| PAYMENT: CAMP TUITION IS $129 FOR EACH REGISTERED PARTICIPANT. This fee includes all classes, use of the park, Saturday concert, camping and R.V. spaces (sorry no hookups), cookout facilities. Significant others, other adults, children not registered for classes, $10 each for the weekend. Bunks for registered students $15 per bunk for the weekend. (Call about bunks for others while they last.) |
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TUITION PAYMENT IN FULL of $ ___________ is enclosed with this registration. Also enclosed: Fee for (how many) _______ significant others or children not registered for classes at $10 each person for the weekend, a total of $_________. Fee for (how many) _______ bunks in bunkhouses at $15 per bunk for the weekend, a total of $ _________.
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| FINAL TOTAL AMOUNT ENCLOSED: $_____________. |
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Payment accepted by check or money order. Producer of the SSAMC is Charles C. Groth. MAKE CHECKS OR MONEY ORDERS PAYABLE TO CHARLES C. GROTH ONLY. Do not write checks/money orders to the Sunshine State Acoustic Music Camp. Send registration form and payment to: DOUG PURCELL, 2045 EAST BAY APT. 703, LARGO, FLORIDA 33771. IMPORTANT: WRITE "CAMP" ON THE FRONT OF THE ENVELOPE BEFORE MAILING. Thank you! See You At The Camp!! |
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