Boston Harbor Scottish Fiddle School 2009

AGREEMENT & PREFERENCES FORM

Please return by July 1 -- Fill out one per camper (Fields marked with a red asterisk * are required.)

Name: E-mail:
*     *

AGREEMENT

Please note that in providing an educational and recreational facility such as "The Boston Harbor Scottish Fiddle School," that the Folk Arts Center of New England is not responsible in any way for injury that might arise from participation in events on or off the premises. Participation and use of the facility is strictly voluntary and carries with it the commonly held understanding that some degree of risk is associated with any and all activities and events. In checking off the box below and emailing back this Agreement, I hereby understand that my participation and presence is voluntary.

Agreed: *     Date: *

RIDES

I can offer a ride   I need a ride

from:   leaving at or around:

HOUSING PREFERENCE

Your age (for housing purposes):
Under 21 years       
21-39 years       
40-59 years       
60+ years

I'd like to room with:

FOOD

If you would like vegetarian food, please sign up now. The kitchen makes only enough for those who have signed up in advance. Note any food allergies, and we'll pass the information on to the Thompson Island kitchen staff.
Would you like vegetarian meals? Yes        No

Do you have any food allergies:

Each year we enjoy a New England clambake, with clams, clam chowder, lobster, and other good stuff! In order to keep waste and costs down, we give the island an exact count of how many lobsters to cook. Would you like a lobster at the clambake? Yes        No

NAME BUTTON

My name, as I would like it to appear on my button:
First name: Last name:

CLASSES

My primary class will be (choose one):

Should time allow, I would also be interested in taking classes in:

Fiddle  Piano  Bagpipes  Other  (specify):

It is important for us to know if there is any time during the week when you will not be at camp.
I will be off-island at the following times:

Who should we contact in case of a medical emergency?
Name: Relation: Telephone:

There are medical personnel on the island at all times, as well as established procedures should an emergency arise which requires off-island care. However, in thecase of a lesser medical situation, it would help us to know who among our campers has medical training. If you are a doctor, nurse, EMT, or have CPR training, and wouldn't mind being asked for help, please indicate your training here:

Doctor  Nurse  EMT  CPR  AED Certification

CAMP ROSTER

Each camper will get a printed roster when they arrive. You can use your Roster to contact your new friends when camp is over. This information is given out ONLY to those actually at camp. Please indicate which items you do NOT want listed on the camp roster. Also, if you are already in our main database from previous years, we will make any changes to the database based on this information (even if you do not want it on the roster).

Do NOT list:       Name       Address       Home phone       Cell phone       E-mail       Website

Please enter your contact information, so that we may double-check it for accuracy.

Name:
Street:
City:
 State: Zip:
 
     Home phone:
Cell phone:
     Email:
     Website:

Any other comments or questions? Write us a note!