Registration Form

2010 Fort New Salem Foundation Dulcimer Festival

Name ________________________________________ Phone ____________________

Address ______________________________________ E-mail address ______________

City ___________________ State _____ Zip __________

Names of Additional Attendees: ________________________________________________

Cost for Festival Pass

____ All weekend ($40* or 45 per person)

____Saturday Only $25* or 30 per person)

____Sunday Only ($20 per person)

Total Enclosed ___________

*$5 discount if received by August 1, 2010

**Make checks payable to Fort New Salem Foundation, Inc.

Send Registration by regular mail to:

Last Updated: June 29, 2010