Registration Form!

First and Last Name:

Parent(s)/Guardian(s) Name(s):

Mailing Address:

City/Town:

Province/State:

Postal Code:

Home Phone Number (with area code):

Alternate Phone Number:

Email Address (the one that you check most, please):

Alternate Email:

Alternate emergency contact name and phone no. (Must be different from parent/guardian):

How old are you, as of August 27, 2012? (Students under 8, contact us):

PLEASE BE ACCURATE - How many years of formal training have you had?:

How many years of fiddle experience have you had?:

I am a present or past member of the Bow Valley Fiddlers or Calgary Fiddlers:
yes
no

If so, what year were you last a member, and what group were you in?:

Have you been to FiddleMania before?:
yes
no

Who is your current violin or fiddle teacher(s)?:

Who were some of your past violin or fiddle teacher(s)?:

What do you hope to get from 2011's FiddleMania?:

Can FiddleMania put your address and phone # on a carpool list for all students in your program?:
yes
no

Do you have any allergies / dietary concerns we need to be aware of? (eg.Peanut Allergy, Vegetarian):

Do you have any medical conditions we need to be aware of? (eg. Asthma, Diabetes):

Will you be providing your own chaperone? (if student is under 11, contact us before selecting "no"):
yes
no

If so, what is the chaperone's name?:

T-shirt size (specify youth or adult):

Any additional questions or requests?:

Please type the text below: