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Barn Dance Historical Society, P.O. Box 68 Wingham , ON N0G 2W0

Pre-Registration for the 13th Annual Jamboree/Campout Weekend

May 27, 28, 29 and 30th, 2010

Blyth Campgrounds and Arena, Blyth , Ontario

Name(s)………………………………………………………………………………………

Address…………………………………………………City/Town……………………………………….

Postal Code………………………….. Telephone Number [……….]…………………

RV License Plate#…………………………………. Membership #(s)……………………………………..

# of Persons in Party . _______ Camping on Thursday _____Friday _____Saturday _____ Sunday ______.

I would like to volunteer as a helper (2 hours) ______.

Non Members - Register prior to Friday, May 15th for the following rates:

Admission to all Events & Camp Site Included
1 Non Member
2 Non Members
TOTAL
 1 Night Stay 
 $49.00 
 $76.00 
  
 2 Nights Stay 
 $71.00 
 $98.00 
  
 3 Nights Stay 
 $93.00 
 $120.00 
  
 4 Nights Stay 
 $114.00 
 $141.00 
  
 ** Extra Arm Bands 
 Number _______
 @ $27.00 each 
  
TOTAL Paid Prior to May 20th
 
  
  

MEMBERS ONLY - Must have a current membership card and number shown above or pay membership fee below. Register prior to Thursday, May 20th for the following rates:

Admission to all Events & Camp Site Included
1 Member
2 Members
TOTAL
 1 Night Stay 
 $38.00 
 $57.00 
  
 2 Nights Stay 
 $57.00 
 $76.00 
  
 3 Nights Stay 
 $76.00 
 $95.00 
  
 4 Nights Stay 
 $94.00 
 $113.00 
  
 Extra Arm Bands For 
 Members – Number_____
 @ $22.00 each 
  
 Extra Arm Bands For Non 
 Members – Number_____
 @ $27.00 each 
  
Sub - total
     
 Membership Fee(for 1 year)
 If not previously paid
  Single $25; Dual $40
  
 TOTAL Paid Prior to May 20th
 
  
  

1. Prices include GST. 2. Continental Breakfast on Saturday Morning by donation. 3. ** Extra arm bands for admission to all events available at time of registration ONLY. Members must show Membership Number for each Extra Armband(s).

Make cheques payable to “Barn Dance Historical Society”; Box 68, Wingham, ON N0G 2W0

Cancellation Policy: We will refund your money if you cancel prior to May 20th, less a $20 admin fee.

No Post Dated Cheques, Returned cheque Fee - $25.00;

Friday Evening Event - Arm bands at Door - $5.00; Saturday Evening Show / Dance Tickets at Door - $25.00

BARN DANCE HISTORICAL SOCIETY

& BLYTH LIONS CLUB

SATURDAY EVENING DINNER AND SUNDAY MORNING BREAKFAST TICKETS

CHEQUES PAYABLE TO “ BLYTH LIONS

 Saturday, May 29th – 4:30PM – 6:30PM – Dinner Tickets

 Number of Dinner Tickets_____________________ @ $14.00 each $______________

 Sunday, May 30th – 7:30AM – 9:30AM - Breakfast (eggs, sausage, hash browns, pancakes, toast and coffee)

 Number of Breakfast Tickets_________________ @ $6.50 each $______________

 Discount rate for both events – Dinner & Breakfast

Number of Tickets__________________@ $18.00 each $______________  

*(includes 1 Dinner & 1 Breakfast ticket)

Name________________________________________________________________

 Address______________________________________________________________

City/Town_____________________________________Postal Code______________

Note: ADVANCE TICKETS ONLY. These are sell out events – Book your tickets early. Enclose your cheque with your Barn Dance Registration. Your tickets will be issued with your registration. If you make your cheque payable to the Barn Dance Historical Society for both the Jamboree Registration and the Lions Club meals, your registration and cheque will be returned to you for replacement registration and chques.