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2021 Dulcimer Chautauqua On The Wabash Registration Form (Only one name per registration form please!)

Name: _____________________________________________________________________________________________

Address: ___________________________________________________________________________________________

City: ___________________________________ State: ___________________________________ Zip: ____________

Phone: (         ) _________________________ Cell: (         ) ________________________

Email: _____________________________________________________________________________________________

Full Participant Package

______ $100.00 Package includes ALL events Thursday - Sunday. AM & PM Workshops/classes, seminars, concerts, hymn sing, & jam sessions.

*No meals are included in the Full Participant or Non-Participant packages!

*If choosing this package please fill out the Workshop/Class Enrollment form indicating first & second choices for each slot.

Non-Participant Package

______ $50.00 Package includes all of the above except the AM & PM workshops/classes.


______ Extra Concert Tickets ______ Friday ______ Saturday Indicate number of tickets for each night. $15.00 each (18 & Under FREE)

______ I would like to volunteer to help at the Chautauqua. Please contact me about areas to help.

______ I need a loaner dulcimer. (No charge)

______ I will need ______ lunch tickets @ $12.00 each for the optional Friday lunch (Catered by Denise Rapp)

______ I will need ______ tickets for the Saturday catered supper  in the Rapp Annex (Catered by Denise Rapp


Make checks payable to: Dulcimer Chautauqua On The Wabash

Mail completed form(s) & check to:

Rick Huffman

1 Parkview Dr.

New Harmony, In. 47631

NO REFUNDS AFTER OCTOBER 7th, 2019

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