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Gotham Acoustic Registration Form

Register one of three ways:

1) Print this form, fill it out, and mail it to us with your payment.
2) By hand, fill out the information from this form and mail it to us with you payment.
3) Fill out and electronically submit this form to us with your credit card information, or mail it to us with your payment.

Mail checks, money orders, and completed forms to:

Village Productions
P.O. Box 816
Burnsville, NC 28714
siteworks@earthlink.net

Make all checks and money orders payable to: Village Productions

Guests & non-students: Use Gotham Acoustic as a convenient, cheap, and safe base for sightseeing, shopping, eating, and having fun in New York City! Downtown Manhattan is a quick ride away.

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View "Clinic Store" Page

Class, Board & Lodging Options:
July 30th & 31st, 2011

Base Banjo Student and Guest Rates (see "More Information" page):

Full Resident Early-Bird rate until July 1: $500
Full Resident beginning July 2: $590
Full Resident Observer (without an instrument): $250
Full Commuter Early-Bird rate until July 1: $425
Full Commuter beginning July 2: $495
Full Commuter Observer (without an instrument): $125
Thursday Commuter: $150
Friday Commuter: $275
Saturday Commuter: $100
St John's Employee & On-Campus Student: $325

Optional Student & Guest Lodging:

Thursday lodging: $85
Friday lodging: $85
Saturday lodging: $85

Optional Student & Guest Lodging with Meals:

Thursday lodging, dinner: $95
Friday lodging, breakfast, lunch, dinner: $125
Saturday lodging, breakfast, lunch, dinner plus Sunday breakfast and lunch: $145
Your Clinic Shirt:
(Included with Registration.)
Texas Orange Kelly Green M L XL 2XL 3XL
Optional Clinic Stuff:
Gotham Acoustic Shirt @ $20 each.
Texas Orange Kelly Green
M L XL 2XL 3XL

(If ordering multiple shirt colors and sizes; note in comment section:)

North Carolina Banjo Clinic Bumper Sticker @ $4 each.
North Carolina Banjo Clinic Hat @ $16 each. One size fits all.
Flat Rate Media Rate Shipping Fee @ $7 each.
What is your Total Dollar Amount?
Payment Method: Mail in Check Credit Card
Credit Card Information: Name on credit card:
Credit Card Number:
Expiration Date:
Minors (under 18) check your age: 17 16 15 14
What classes will you be attending? Jam Class Fiddle Mandolin Flatpicking Guitar
What is your playing level?
(Levels described on home page)
Novice Beginner Intermediate Advanced
What style do you prefer? Old Time Bluegrass Both
You are free to study multiple instruments. Will you? YES NO
Will you be arriving via the subway? YES NO
If Yes, please list your travel cell number:
Where did you hear about our clinic?
Acoustic Musician Bluegrass Unlimited Flatpicking Guitar
Mandolin Cafe Fiddle Hangout Old Time Herald
Charlotte Folk Society Fiddler Magazine Music Store
From a Friend Bluegrass Association Radio
Music Teacher Other (please comment below)
Comment Section:
Your Information:
Date:
First name:
Last name:
Address:
City:
State:
Country:
Zip:
Phone:
Cell Phone:
Email:
I Am Aware of My Need to Procure a St. John's "StormCard" to Attend. YES NO
Register:

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