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MERIMBULA JAZZ FESTIVAL INC.

Celebrating 30 Years of Jazz in June

30^th Festival: 11-14 June 2010

MUSICIAN REGISTRATION FORM

MUSICIANS REGISTRATION FORM $10.00

PLEASE PRINT CLEARLY. Badge No. ___________________

NAME: ______________________________ Preferred Badge Name: _________________

ADDRESS: _____________________________________________________________________

________________________________________________________POSTCODE _____________

HOME PHONE: _________________ Ph. No WHILE IN MERIMBULA _____________________

MOBILE: ______________________EMAIL ____________________________________________

INSTRUMENT PLAYED: ______________________________________

· To register as a Musician you must be in a Registered Band and perform on the Official Program.

· At the Festival please make Band Leaders and Stage Managers aware that you are correctly listed in the Stage Book – and wear your badge.

· Musicians may be listed in a maximum of two (2) bands. You can perform in any number of bands if you can fit it in, but only the two nominated by you will be given preference in programming. Please check with your Band Leader.

Indicate below the name/s of your nominated band/s.

1. ________________________________________________________________________________________

2. __________________________________________________________________

A CONCESSION (ONE ONLY) IS AVAILABLE TO REGISTERED MUSICIANS FOR REGISTERING THEIR PARTNER, SCHOOL OFFICIAL OR PARENT - FEE $35.

IF APPLICABLE, PLEASE COMPLETE THE INFORMATION BELOW:

FULL NAME: __________________________ Preferred Badge Name: ______________________

NOTE

THIS FORM MUST BE ACCOMPANIED BY PAYMENT. CHEQUE OR MONEY ORDER TO BE MADE

OUT TO ‘MERIMBULA JAZZ FESTIVAL INC’ – THANK YOU.

Postal address: PO Box 415, Merimbula NSW 2548

Phone/Fax: 02 64950673 Jazz Phone: 0419 445011

Email: info@merimbulajazz.org.au Website: www.merimbulajazz.org.au