FallFling Registration Form

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FallFling Registration Form

(Note: A confirmation of your registration (and payment, if paid), plus directions will be emailed or snail-mailed out around September 1; registrations received after that date will have confirmations emails out within a week of receipt.)

You may fill out or send one form for your entire family, all related, living at one address, but please fill out separate forms for roommates or friends.

* = Required Fields

*Legal Name (& Nickname) (1):
*E-Mail Address (1):

Legal Name (& Nickname) (2):
E-Mail Address (2):

*Address:
*City: *State: *Zip:

Home Phone:
Cell Phone:
Work Phone:

MINORS:

If you are bringing YOUR children with you who are under the age of 18, list their names and ages here. If YOU are the parent or legal guardian, there is no need to fill out a separate registration form for your children; but by listing their names here you are assuming responsibility for them while they are at the festival under the strictures of the waiver on the back of this page.

Full Name/Age:
Full Name/Age:
Full Name/Age:
Full Name/Age:

If you are bringing children with you who are under the age of 18, and you are NOT the parent or legal guardian, please: a) list their names and ages below; b) have the parent or legal guardian fill out a Minor's Registration Form & Waiver for each child.

Full Name/Age:
Full Name/Age:
Full Name/Age:
Full Name/Age:

Any allergies or medical problems we should know about? (Please tell us *who* these conditions apply to!)

Are you vending? Please read, print, and fill out the Vendor Information Form and send it in with your registration form and payment. NOTE: Vendors do not qualify for discounted admission, but you also do not have to volunteer for a job when you arrive. Deadline for vendors is SEPTEMBER 23 - NO EXCEPTIONS!!!

Do you want to hold a class or a ritual? Please fill out the Class and Ritual Volunteer Form and send it in with your registration form and payment. NOTE: Leading a class or ritual counts as part of your community service to the festival, and does not grant you free or discounted admission (sorry!). Deadline for classes and rituals is SEPTEMBER 23 - NO EXCEPTIONS!!!

Do you want to bring a pet or service animal? Please read and fill out the Pet/Service Animal Application Form.

GENERAL WAIVER AND INFORMED CONSENT TO PARTICIPATE

*(1) I (Legal Name),
and (2) I (Legal Name),
having read and understood the rules and standards of conduct expected while at Cherokee Farms, freely consent to these. Being a voluntary participant at FallFling 2011, at Cherokee Farms, Lafayette, Georgia, October 6-9, 2011, I agree to abide by the above rules and regulations. I also understand that if I do not abide by these, I may be escorted from the site without refund. I also agree to hold harmless the owners of the site of Cherokee Farms, the organizers and staff of FallFling, and all its representatives, from all claims, actions, expenses and demands in respect to injury, loss or damage to my person or property, however caused, arising in connection with my participation even if the same may have been contributed to or occasioned by the negligence of the owners, the said body, or of any of its representatives.

Please type your full legal name below; this will be your electronic signature)

*(1) Signature (parent sign for minor under 18 years of age)
*Date signed:

(2) Signature (parent sign for minor under 18 years of age)
Date signed:

Method of Payment:
I will be paying via PayPal momentarily
I will be mailing a check or money order (paying whatever the current price is when I mail my check)
I will be paying at the gate ($60 cash weekend price)
I will be paying at the gate ($25 cash daytrip price)

PLEASE PRINT A COPY OF THIS PAGE FOR YOUR RECORDS, *BEFORE* CLICKING THE SUBMIT BUTTON BELOW!!

Note: A confirmation of your registration (and payment, if paid), plus directions will be emailed or snail-mailed out around September 1; registrations received after that date will have confirmations emails out within a week of receipt.

When you click the button below, you will be taken to the captcha confirmation page. I can't seem to make it send you to the PayPal Payment Page automatically, so just hit your BACK button, come back here, and click the link below to pay via PayPal:

CLICK HERE TO PAY VIA PAYPAL

Ready ? Ok, but before you click 'Send Form' please insert the same letters and numbers you see in this image into the box to your right ->
:

If mailing this form with a check, please note below what you are paying for.
(NOTE: Current price only good if payment accompanies registration.) Prices per person:
Postmarked and paid by July 1, 2011
$30.00
$________
Postmarked and paid by August 15, 2011
$40.00
$________
Postmarked and paid by September 23, 2011
$50.00
$________
After September 23
$60.00
$________
Daytrip for Saturday only
$25.00
$________
Only pay for one child age 11-17, at 1/2 price! All other kids are free! (Must be in immediate family, same address as registering adult)
Children 11-17
1/2 price
$________
Children 10 and under, or 2nd or more child
Free
$________
CST members get $5 off above prices (please email me for a CST payment link)
Pet Fee
$35.00
$________
Vendor Fee up to 250 sq ft space (did you send your Vendor Info Form?)
$10.00
$________
Vendor Fee up to 500 sq ft space (did you send your Vendor Info Form?)
$20.00
$________
Vendor Fee up to 1000 sq ft space (did you send your Vendor Info Form?)
$30.00
$________
Vendor Fee up to 1500 sq ft space (did you send your Vendor Info Form?)
$40.00
$________
Vendor Fee larger than 1500 sq ft space (did you send your Vendor Info Form?)
$50.00
$________
Total enclosed: $________

MAKE CHECKS OUT TO LINDA KERR; mail form and check to:

Linda Kerr
425 Webster Rd. #710
Auburn, AL 36830