Moondance 2014

Moondance 2014 Registration Form

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

IMPORTANT:
1) PLEASE PRE-REGISTER AND PRE-PAY!! Because there is limited parking space at Roxanna, any festivals there are capped at 100 attendees. The land just will not hold any more people and cars than that. Precedence will be given to those who have pre-paid; this includes day-trippers.
2) Directions will only be sent to those who pre-register. You may pay at the gate (if the cap of 100 people has not yet been reached when you arrive), but please let us know you'll be there. Also, we need to know how many to plan for, so we can have enough portapotties.

Gate Payments:All payments at the gate MUST BE CASH OR MONEY ORDER, and will be the full price of $50 weekend or $20 daytrip, regardless of when you register! NO CHECKS AT THE GATE.

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:

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.

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 discounted admission (sorry!).



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 Roxanna, freely consent to these. Being a voluntary participant at Moondance 2014, at Roxanna, near Auburn, Alabama, May 22-26, 2014, 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 Roxanna, the organizers and staff of Moondance, 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, full weekend ($50 cash)
I will be paying at the gate, daytrip, Fri, Sat, or Sun ($20/day cash)


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

When you click the button below, you will automatically be directed to the PayPal Payment Page. NOTE: If you just want to mail a check or money order, or pay at the gate, go ahead and click the button, but then simply ignore the PayPal page, and hit your Back button to come back to this page; if you want, you can print this page and mail with your payment to the address below (a good idea if you're paying for multiple things). Your registration information that you filled in above will be sent to me automatically.



If mailing this form with a check, please also print the Prices page and note on it what you are paying for.