Now a easy "Pull Down" button. Select the item from the pull down menu and enter the attendees' name. At the Pay Pal Cart, To add from a different category (like another adult, children or Vendor Space) hit the continue button. Check out when finished and that's it. Make sure you mail in your signed forms (Registration) <==Click here to Download! when completed. We look forward to seeing you.

PLEASE NOTE: 

Chrysalis Moon 2012 – Registration Form

All payments must be post-marked by June 27, 2012.

You may state which Unit (area) and cabin you prefer. First-come, first-serve. Please state a second choice.

 

 Vendor Fees:

 

FULL FESTIVAL

 

Registration For:	Until 5/15/2012	Until 6/27/2012
Adults	$75.00	$85.00
Children:
Ages 0 to 11	Free!	Free!
Ages 12 to 17	$15.00	$15.00

Children 0 to 17 are with legal parent or guardian only!

Discounts: College Students (age 18+ with college ID) or members of PEN

 

 

 

T-shirts

CM 2012 t-shirts will be available on a pre-order basis only, delivered during the festival.  State if you prefer a Male or female cut t-shirt.  Please note the prices and sizes available below.

T-Shirt Sizes	Prices
Adults Sm -XL	$16.00
Adults XXL - XXXL	$18.00
Adults 4XL - 5XL	$20.00
Children’s Sm - L	$15.00

 

Hold my spot!   We know you’re busy, you’re broke but optimistic.  Just check the box and send $20.00 and a completed registration form and signed waivers for each adult, and we will save you a space.  Please remember the $20.00 is nonrefundable, and full amount of all registration fees are due by June 27, 2012 or both fee and space will be forfeit with no exceptions.

 

New Payment Option Plan for Chrysalis Moon 2012

 

We are attempting something new this year.  To help ease the burden of coming up with the full amount of registration fees all at once, we are instituting a payment option plan.  If you chose this option, all rules must be adhered to with no objections.

 

The payment option rules:

 

• The full amount of all registration fees will be divided into 3 (three) equal parts.

• Each payment is to be made monthly.

• The first payment must be accompanied with all registration and signed waiver forms.

• Pay Pal is not an option for this payment plan.

• Note: Your e-mail address must be stated on the registration form.  You will be reminded each month by e-mail prior to the payment due date.

• Last date to take advantage of the payment option plan is April 27, 2012.

• If final payment is not postmarked by June 27, 2012, all registration fees will be forfeit with no refund, no exceptions.

 

Example:

 

If 2 adults register on April 27, 2012, the total registration fee is one hundred and fifty dollars ($150).

Fifty dollars ($50.00) will be sent in with a completed registration form and signed waivers.

On May 27, 2012 the second payment of fifty dollars ($50.00) is due.

On June 27, 2012 the third payment of fifty dollars ($50.00) is due

 

Remember, no matter what month you choose to start the payment plan, the last payment is due (postmarked) no later than June 27, 2012.

 

Check or money order made to: Chrysalis Moon

 

Mail all forms and payments to:

Joe Gladkowski

1310 Clement St.

Joliet IL  60435

 

Note: Payment Option Plan on envelope

 

Cancellation/Refund Policy:

 

Written cancellation requests received by June 27, 2012 will be refunded in late July minus half of the registration fee for processing.  If request is made after June 27 there will be no refund request granted.

 

Supplemental Registration Information

(Please attach to registration form if you copy for others)

 

Festival Date:  Wednesday, July 11, 2012 through Sunday, July 15, 2012

 

Festival location:

Tippecanoe River State Park

4200N US 35

Winamac, IN 46996

Phone: 574-946-3213

Website:  http://www.in.gov/dnr/parklake/2965.htm

 

 

This is an all-cabin camping event.  Each registrant will be assigned a bunk in a cabin.  There are 4 camping units (Earth, Air, Fire and Water). Each unit contains one lodge and 7 cabins of various capacities.

 

• 8 cabins with 2 beds

• 2 cabins with 3 beds

• 4 cabins with 4 beds

• 14 cabins with 5 beds

• 4 twelve bed lodges all with electricity ($5 per adult additional).  Persons with special need for electricity (e.g. uses a C-PAP machine) will be given first priority to the lodges for no additional bed fee. 

 

 Sharing is encouraged…

Please list here the names of others you wish to share a cabin with:

 

If you wish to have a private cabin, there will be an additional $15 per empty bed charge,

For example:

 

Two people register at $75 each ($150).  They choose a 5-bed privacy cabin option.  So the fee would increase by $15 per empty bed or $45 for the 3 additional empty beds, for a total of $195.

 

For a private cabin, state the number of beds you would like from the list above: ____________ and add the additional fee to the registration form above.

We will attempt to honor all requests.  We will do our best to accommodate everyone with a possible a bit of moving around once we’re all on site.  Cabin choice cannot be guaranteed.

You will be notified of your cabin assignment in your festival confirmation letter.

 

 Tent Camping is available at an additional fee.  The tent camping area is approximately ½ mile from the festival location—walking distance for most people.

 

Park entrance fee: $5.00 for Indiana residents or $7.00 for non-residents