Stellar Days & Nights - February 21-24, 2008
Registration Form

Reserve your spot!
Mail this form & check (payable to Arkansas Valley Music & Dance (AVMAD)) to:
Andrea Earley-Coen
Stellar Registrar
15590 CR 162
Nathrop, CO 81236

OR Cut and Paste this sheet into an email and send to:

Full Name 1 ______________________________

Name for Button ______________________      Gender: ___

Food preference:    ___Omnivore    ___Omnivore Non-dairy   ___Veggie (Dairy OK)    ___Veggie Non-dairy

Email __________________________________ Phone number ___________________________

Mailing Address ______________________________

City __________________________   State ________   Zip ________

Please do not publish:    ___ Email    ___ Phone    ___ Address

Carpooling:    ___ I’m looking for a ride    ___ I can give a ride


Full Name 2 ______________________________

Name for Button ______________________      Gender: ___

Food preference:    ___Omnivore    ___Omnivore Non-dairy   ___Veggie (Dairy OK)    ___Veggie Non-dairy

Email __________________________________ Phone number ___________________________

Mailing Address ______________________________

City __________________________   State ________   Zip ________

Please do not publish:    ___ Email    ___ Phone    ___ Address

Carpooling:    ___ I’m looking for a ride    ___ I can give a ride


If available, how many of each would you buy:    ___ Tee shirt    ___ Women’s v-neck long sleeve    ___ Tote bag   ___ Visor

How did you hear about the weekend? ______________________________________

I recruited ______________________________________________________________

Payment (see cost page for more info):

  Amt   No.of people   No.of nights   Total
Regular Registration $230 x _______ x NA = _______
Non-Dancer Registration $180 x _______ x NA = _______
Youngsters ages 11-17 $150 x _______ x NA = _______
Youngsters ages 5-10 $100 x _______ x NA = _______
Youngsters ages 4 and less Free x _______  
Cabin Housing +$20 x _______ x _______ = _______
Private Housing* +$35 x 2 x _______ = _______
Late Registration +45 x _______ x NA = _______
Donation to Stellar - tuition does not fully cover costs           = _______
Work Exchange*** -$10/hour x _______ hrs     = _______
            Total Due _______

Make checks payable to Arkansas Valley Music & Dance (AVMAD)

Or send payment to via PayPal® (from checking source only)

Total Amount Enclosed: ______ OR I have sent this amount via paypal: ____

*If Private Housing, rank your choice in each category (1st, 2nd).
TYPE OF BED:    ___ Double    ___ Two twins
DISTANCE FROM LODGE:    ___Close to Lodge    ___ Quiet, 3/4 mile away
All private rooms are double occupancy only - make sure to designate your roommate.

***WORK EXCHANGE & NEED BASED SCHOLARSHIPS APPLICATION
A limited number of Work Exchanges and Need-based Scholarships are available. Work 3 to 8 hours during the weekend and get $10 per hour of work off your tuition! An additional $50 off will be awarded to 6 individuals based on need. Work will include setting up for meals, washing dishes, cleaning the Lodge, cleaning cabins, and other miscellaneous tasks. If this interests you, complete this application and pay to reserve your spot. If you are not awarded an exchange and cannot pay the additional amount needed to attend, we will refund the full amount paid.

Name ____________________________________

Could you attend without this Work Exchange? ____   How many hours would you like to work?__

Need-based Scholarship applicant (additional $50 off)?    ___ Yes    __No
If yes, please explain ____________________________________________________

Describe any work experience you have at this or other camps: ______________________________________________________________

Most help is needed before and after the weekend and around meal times. Please circle all times you are willing to work.     Prep day (Thursday)        Clean-up day (Sunday)        Morning        Mid-Day       Dinner time