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2019 Dulcimer Chautauqua On The Wabash Registration Form (Only one name per registration form please!)
City: ___________________________________ State: ___________________________________ Zip: ____________
Phone: ( ) _________________________ Cell: ( ) ________________________
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.
______ $60.00 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
______ I plan on attending the Spaghetti Supper at the Baptist Church on Saturday night. *Please indicate number attending
so that the church can plan meals accordingly _____
Make checks payable to: Dulcimer Chautauqua On The Wabash, Inc.
Mail completed form(s) & check to:
1 Parkview Dr.
New Harmony, In. 47631
NO REFUNDS AFTER OCTOBER 7th, 2019