PUNTA GORDA BANJO BASH

REGISTRATION FORM

February 17th, 18th, and 19th 2011
Charlotte County Event Center
Punta Gorda, FL

Name:____________________________________________________________

Spouse/ Guest:_____________________________________________

Address:__________________________________________________________

City, State, Zip:_____________________________________________________

Phone;____________________________________________________________

Date of arrival _____________________________________________________

Do you wish to perform? YES ____ NO ____

Please include name of group & players you will be playing with on the reverse.

Are you part of a large performing group? _________ How manyMembers? ___

Do you need display space? ______ How many Tables?___________________

Registration $30.00 per attendee, $5.00 for spouse or guest. Children under 12 are free.

Kindly return this form with your registration check payable to;

Gulf Coast Banjo Society
P.O. Box 511927
Punta Gorda, Fl 33951

NOTE: Members of the Houston All Stars will need to register but are exempt from paying the registration fee their parents and /or guardians must register and are responsible for their own registration fee.

ALL PERFORMERS PLEASE NOTE:

APPROPRIATE STAGE ATTIRE IS REQUESTED.