Print out Registration page:
Print this form and Register for: 2005 INSPIRATION IN MUSIC COURSE
$50 non-refundable deposit due June 1st, 2005
FULL PAYMENT DUE July 1st, 2005
*Early bird payment bonus May 1st, 2005

TUITION: (Category #1)
Inspiration in Music
6 nights, 6 Days, July 24-29 $600 ______

DISCOUNTS!
Current MFP member or YI teacher -$100 $500 ____
Join MFP ($50/receive $50 discount -$50 $550________
Early Bird Discount (including free CD) -30 -$30____
(full payment by June 1st)
Subtotal Category #1 $….________

HOUSING and meals: (Category #2)
Room/all meals/facilities use/recreational activities. (Based on double occupancy)
Linens included. T-Shirt included with the course. Includes 3 meals a day. Excellent food!
5 Nights, 6 days

Based on DOUBLE Occupancy and includes meal plan.
$75 for double per day (5 nights, 6 days) $375 ___
Additional dorm accommodation Sun 7/23 $50 ____
Additional dorm accommodation Fri7/29 $50 ____

$110 for SINGLE room per day(5 nights,6 days) $550 ____
Additional dorm accommodation Sun 7/23 $75 ____
Additional dorm accommodation Fri7/29 $75 _____
Subtotal Category #2 $….. ______

FOOD:
Commuters may purchase meals at a fee of approx:
$24/day: $7 Breakfast, $7 lunch, and $10 dinner.
No advance purchase is necessary


Add TUITION (Category #1), HOUSING (Category #2)
Category #1 plus #2
TOTAL of two Categories: __________
DEPOSIT DUE June 1st , Balance Due July 1st
Deposit: $50 ____
Partial Payment: $ ____
Balance Due July 1st $ ____

VISA-MASTER CARD ACCEPTED
Name (as it appears on your card):______________________________________
Credit Card Type and # ______________________________________________
Expiration Date:____________________
Billing Address if different from registration address:_______________________________

NO REFUNDS OF TUITION AFTER JULY 1ST
DORMATORY CANCELLATIONS ACCEPTED UNTIL CHECK IN
EARLY BIRD REGISTRATION BONUS: FULL PAYMENT BY JUNE 1ST RECEIVE COMPLIMENTARY CD AND $30 TUITION DISCOUNT!!!
Health forms and maps to campus will be sent upon receipt of deposit/registration. You will be sent confirmation and billing balance by June 15st.

I plan to arrive by car____ , bus____ , air____
Arrival date and time: ___________________
I will have my car/van during the course_____
PLEASE SEND: $50 RESERVATION NON-REFUNDABLE DEPOSIT BY JUNE 1ST

Submit Payment to and make checks payable to:
Young Imaginations
70 Skyview Terrace
San Rafael, CA 94903
Voice mail messages:
Between 10:00a.m. and 9:30 p.m. West Coast Time please.
Barry Green (510) 339-3339
Cell-(510) 685-2544 (emergency only)
Fax: (510) 339-3309
e-mail: barry@innergameofmusic.com

Brochure e-mail registration on web @ Innergameofmusic.DarlingGreen/
Last Name_______________________
First Name_______________________
Street_____________ City_________ State___ Zip _______
Age_____, Sex_________
Phone (___)_________ Emergency Phone (___)____________
Parent Name (under 18)________________________________
Work Phone (___)_______________________
NO REFUNDS OF TUITION AFTER JULY 1ST DORMATORY
CANCELLATIONS ACCEPTED UNTIL CHECK IN
Your instrument or Voice:
Second instrument (if applicable)
Other interests:
What inspired you to register for this course:
What would you like to take home from this experience?

The undersigned applicant, or parent if the applicant is a minor, releases the workshops management and the workshops facility of all liability in the even of accidental injury. Due to commitments to the faculty and the workshop venue, no refunds will be given after July 1st. Late registration will be accepted based on space available. The individual who signs the registration form understands and agrees to these terms and agrees to abide by all University rules as stated in the introductory meeting the first day of the workshop. There will be adult male and female supervision of all campers under 18 staying in the dorms 24/7. There will be a late night curfew enforced based on age of participants. The camp and dorm rooms will be drug and alcohol free. This policy will be strictly enforced. Skate boards or skating of any kind is not allowed on campus. An emergency medical form is required of everyone (any age) staying in campus housing .

Signature of Applicant_____________________________
Parent if under 18________________________________
Date______________________