Palmetto Fiddle Camp Registration form
January 24 and 25, 2014 at Palmetto
Island State Park
Name
(Print)__________________________________
Email___________________________________
Phone__________________________________
Other contact Information you wish to
share________________________________________________________________________________________________________________
Signature________________________________
A Non-refundable deposit of $50.00 required
for registration.
Total Payment of $110.00 includes lessons,
facility use and concert.
Payment may be made to Randy Frederick in cash or check. No credit cards.
Randy Frederick
7114 Windmill LN
Lake Charles, LA 70605
January 24 and 25, 2014 at Palmetto
Island State Park
Name
(Print)__________________________________
Email___________________________________
Phone__________________________________
Other contact Information you wish to
share________________________________________________________________________________________________________________
Signature________________________________
A Non-refundable deposit of $50.00 required
for registration.
Total Payment of $110.00 includes lessons,
facility use and concert.
Payment may be made to Randy Frederick in cash or check. No credit cards.
Randy Frederick
7114 Windmill LN
Lake Charles, LA 70605