Print out and complete this form, or write out the information on a separate sheet:
Sign me up for The Colorado Jam Camp Weekend!
Please confirm my registration and send full orientation info.
For accommodations click here.

There is still room in this camp. To register, please contact Pete Wernick.

[ ] REGULAR TUITION ($225)
[ ] $95 deposit enclosed, $130 due on arrival.

Name: ________________________________________________

Address: ______________________________________________

City, State, Zip: _________________________________________

Main telephone: ________________________________________

E-mail: _______________________________________________

Check which instruments you play, and circle the main one:
[ ] guitar   [ ] banjo   [ ] mandolin   [ ] fiddle   [ ] bass
[ ] resonator guitar (dobro)   [ ] other: _____________   [ ] none

Can you "fake" solos on your instrument?
[ ] no   [ ] sometimes   [ ] usually

Experience playing bluegrass with others:
[ ] occasional jamming   [ ] extensive jamming   [ ] band member

Singing experience: [ ] sing lead   [ ] can lead a song   [ ] harmony

How did you FIRST hear about this camp?
___ DrBanjo.com
___ magazine ad (which magazine?________________________)
___ radio (what station? ____________)
___ article in newspaper or magazine (which one?_____________)
___ the festival's web site
___ flyer (where?_______________________________________)
___ Dr. Banjo email newsletter
___ music teacher (who? _________________________________)
___ from a former camper (who? ___________________________)
___ other: _____________________________________________)

Mail to DR. BANJO 7930-P Oxford Rd. Niwot, CO 80503.
Checks payable to Dr. Banjo.