Name:

Address:

City:

Province/State:

Age (if under18):

Parent's Email:

Country:

Postal/Zip Code:

Phone Number:

Email Address:

Parent's Name:

If not accompanying child -
Parent's Work/Cell phone:

Which week would you like to attend?

Week 1 July 19 - 22 / 10
Week 2 July 26 - 29 / 10
Week 3 Aug 2 - 5 / 10

What instrument will you take lessons on?

Guitar
Piano
Fiddle
Bass
Mandolin
Drums (week 1 only)

To help us pre-plan our primary guitar class sizes, indicate what class you want to take.

Fingerstyle (Wk 3)
Gypsy Jazz (Wk 2 only)
The Variety Pack (Week 1 and 2)
Country/Bluegrass (all weeks)
Blues (all weeks)
General Guitar Fundamentals (all weeks)
Very Beginner TWO DAY 'Strum and Sing' (week 3, Aug 2-3)
No specific classes in mind

What is your playing level? Beginner Intermediate Advanced

If your week of choice is full, can you attend any other week:

REGISTRATION INFORMATION

• Early Bird Incentive: Register by May 1st and deduct $25 from your total. No early bird deduction for Two Day Guitar Class. Registration Deadline is June 20/09. Later Registrations WILL BE ACCEPTED if space is available.
• Family Reduction If three or more immediate (parent/child) family members attend camp deduct $50 per person.
• Equipment Rental can be arranged and picked up for you at your cost. Please arrange this with the camp no later than June 20th.
• Deposit of $250 (for Four Day Class) or $100 (Two Day Guitar Class) by Paypal, cheque or money order will reserve your space. One deposit per person. Balance due upon arrival.
• Cancellation Policy: For cancellations prior to July 1, half of the deposit will be refunded. ($125 for Four Day class and $50 for Two Day Guitar class) If total was paid, refund will be all but $125 (Four Day class) or $50 (Two Day Guitar class) No refund for cancellations after July 1st.

Please indicate if a non participating guest (s) will accompany you and if they require meals / trailer rental. Trailer rental $60/ person, meal package $100 (or buy individual meals). Call for family rates for trailer rental.
Individual meal prices Breakfast $5, Lunch $10, and Dinner $13 (Canadian funds).

Indicate in box below if a non-participating guest will accompany you and if they will require meals and trailer rental. Also indicate if you or your guests have food intolerances/allergies or require vegetarian meals.



How Our Paypal Payments Work:

• You can choose to pay for your entire package or the deposit only
• If paying entire package prior to May 1, we'll re-emburse your $25 Early Bird Deduction
• If paying deposit only, your $25 Early Bird Deduction will be deducted from your balance owing. Balance due upon arrival to camp. No early bird deduction for Two Day Guitar Class.
• Family Rate Reductions, Family Trailer Rates and Bursary Funding will either be re-imbursed (if paying total) or deducted from your balance owing (if paying deposit only), if applicable.
• If you indicated in the box above that someone will accompany you and needs meals/trailer rental, their costs will be payable upon arrival to camp.
• All costs will be summarized in a confirmation letter that we'll send you after we receive payment. A receipt will be issued for your total upon arrival to camp.
• If you need assistance calculating costs or need info on family trailer rental rates, call us at 306-749-2498.
• If you are registering and paying fees for more than one person.
  Please pay the total of all registrants with Pay Pal but register and submit each person on a separte form.

I have paid, or will pay, using Paypal

I will submit a cheque or money order with this form by mail
Mail your registration and deposit (by cheque or money order) payable to
Pelletier Guitar and Music Camp to: Box 648, Birch Hills, SK. S0J 0G0
You may send us your registration electronically or by
Fax: 306-749-2732, or Phone: 306-749-2498. Deposit must follow to hold your reservation.