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WORLD CAMP, September 29th (Thursday) - October 2nd (Sunday), 2022 / Iroquois Springs, Rock Hill, NY -USA
PLEASE NOTE THAT VACCINATION PROOF IS REQUIRED.

BY MAIL REGISTRATION FORM - Print, fill out and mail to address below

Name(s):______________________________________________________

Address:______________________________________________________

City, State, Zip:_________________________________________________

Phone:________________________________________________________

Email:_________________________________________________________

Accommodations - check one:

Women's cabin:__________  Men's Cabin:__________  Coed cabin:__________ Private cabin:__________

If you wish to be roomed with someone, list all names.
_______________________________________________________________________________________________

________________________________________________________________________________________________

ALL persons must indicate preferences here:

Food Preference

No Restrictions:_______ Vegetarian:_______ Other (please explain):__________________________________________


Registration Fees Enclosed (please complete):

Entire Weekend Private  --------------------------------------------------------------#_____persons @ US $545.00 each___________

Entire Weekend Dorm  ----------------------------------------------------------------#_____persons @ US $455.00 each___________

Two full days & nights Private (Friday + Saturday) -----------------------------#_____persons @ US $475.00 each___________

Two full days & nights Dorm (Friday + Saturday) -------------------------------#_____persons @ US $395.00 each___________

I would like to rent a bedding from the camp -------------------------------------#_____persons @ US$ 35.00 each____________

I would like to purchase camp VIDEO ----------------------------------------------#_____ @ $65 each________________________

I would like a Shuttle service (around trip) from Newark Airport---------------------#_____persons @ $150 each___________________


TOTAL ENCLOSED ---------------------------------------------------------------------$_______________________________________

If you will be or interested renting a car and would like to give a ride or share the cost, please let us know (include your flight info).

Waiver of Responsibility World Music and Dance Camp does not cover bodily injury to any person participating
in dance or other activities which we sponsor or which are conducted on premises we rent or use. Your registration
signifies acceptance of the above statement and that you personally assume responsibility for any medical costs incurred.

Please mail this form with payment in US. funds to:

World Camp c/o Ahmet Luleci
16 Braeland Ave.
Newton Centre, MA 02459 - 2211

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