Swing Out New Hampshire - Lindy Hop Dance Camp

Swing Out New Hampshire 2008
ON-LINE REGISTRATION FORM

Please submit the following form online. After you submit the form, please send your full payment or a deposit of at least $200 to:

      Swing Out New Hampshire
      c/o Mark Kapner
      31 San Marino Drive
      San Rafael, CA 94901

Make out checks to Swing Out New Hampshire, LLC. Checks or money orders must be in US funds, and MUST be payable by a US bank. The US bank's name must be printed on the check or money order. You will be responsible for any bank collection fees if these instructions are not followed.

You may also send your payment online through PayPal.

Your registration is not complete and your space is not guaranteed until we receive your full payment.

Please fill out a separate form for each person registering.

First Name:

Last Name:

Address:

City:

State:

Zip Code:

Country:

E-mail Address:

Day Phone:

Evening Phone:

Cell Phone:

Were you at Swing Out New Hampshire 1999? Yes No

Were you at Swing Out New Hampshire 2000? Yes No

Were you at Swing Out New Hampshire 2001? Yes No

Were you at Swing Out New Hampshire 2002? Yes No

Were you at Swing Out New Hampshire 2003? Yes No

Were you at Swing Out New Hampshire 2004? Yes No

Were you at Swing Out New Hampshire 2005? Yes No

Were you at Swing Out New Hampshire 2006? Yes No

Were you at Swing Out New Hampshire 2007? Yes No

Meal Preference Vegetarian Non-Vegetarian

I prefer a 24 Hour "Quiet Camper Cabin" Yes No

I would like to share a cabin with:

Before completing the next part of the registration form, please read the entire Class Levels Page.

When you tell us about your dancing, you are not signing up for a specific level. After getting your input and checking with your teachers, we will assign you to a level in accordance with the factors mentioned in our Levels Information

If you see yourself as a Level 4 dancer, please send us a specific recommendation from one of the SONH instructors. If you think you won't be able to interface with an SONH instructor, please let us know right away.

Based on the Levels Descriptions, I see myself fitting into (choose 1):

Level 2A Leader
Level 2B Leader
Level 3 Leader
Level 4 Leader

Level 2A Follower
Level 2B Follower
Level 3 Follower
Level 4 Follower

I think my dancing skills would place me in the Lower Half Upper Half
of the level I indicated.

NEW: Please email or mail us a photo showing your face clearly. This will help us in sorting out the levels. Email to mark@swingoutnh.com

For past year only, please describe:

On-going Lindy Hop classes you have taken and with what teachers. Please also use this space to tell us anything else you think we should know about your dancing:

The teacher who is most familiar with my dancing is:

His/her email address is:

How did you hear about Swing Out New Hampshire?

I am a Slow Average Fast learner in dance classes.

Workshops you have attended.
List the five most important ones, one to a line:

1.
2.
3.
4.
5.

Camps you have attended (the 4 most recent ones),
and what level you were at:

Exchanges you have attended in the past year.
List the four most important ones, one to a line:

1.
2.
3.
4.

Times per week you social dance Lindy Hop:

My greatest Lindy Hop strength is:

My greatest Lindy Hop weakness is:

Tuition - $645 with Meals and Housing	$
Tuition - $575 without Housing	$
Semi-Private Housing is full. You can register for Regular Housing and join a wait list for Semi-Private if you wish.
Linen and Blanket Rental ($20)	$
Boston Bus ($90)	$
Total Due	$
Amount Sending (minimum $200)	$
Balance due by July 15th	$
Waiver: When you arrive at camp, you will need to complete and sign a copy of the following Camper Agreement and Waiver of Liability. You do not need to send a copy now. Camper Agreement and Waiver of Liability I will not swim in the pool or lake at any time except during posted hours when there is a lifeguard on duty. I will obey all instructions given by the lifeguard and leave the water if requested. I will not smoke in any building or on the porch of any building. I will smoke only in designated smoking areas. I will thoroughly extinguish all matches and cigarettes, scatter the tobacco and put filters in a trash can. I will not light any candles or incense in any building. I will not possess or consume any alcohol or illegal drugs on the Camp Wicosuta property. I understand that these rules exist for the safety and comfort of all participants. Violation of any of these rules will result in my being required to leave Swing Out New Hampshire immediately without refund of any camp fees. I realize that my image might appear in photographs and/or videos taken by representatives of Swing Out New Hampshire, LLC. I agree to let Swing Out New Hampshire, LLC use these images for any purpose and that these images shall be the sole property of Swing Out New Hampshire, LLC. I recognize the active and strenuous nature of dancing and the rustic nature of Camp Wicosuta, and I agree to hold harmless Swing Out New Hampshire, LLC, and Lakeside Retreats, LLC and their various directors, employees, agents, successors and assigns from any and all claims, causes of action, suits or liability, costs and expenses (including, without limitation, reasonable attorneys' fees) for any loss or injuries that I may sustain as a result of my attending this event and participating in any activities while here. I agree to dance in a safe manner to protect myself and those around me from the possibility of injury.

Please type the code shown in the image:

Please click this submit button once only.

Please be patient as it may take a little time for this form to go through. Clicking more than once will not speed up this process and will result in multiple applications be submitted.