Circus Kumarani Dargaville

Registration Form

5th Northland Circus Festival: 22nd–24th January 2010

3-day Weekend Pass for $50 suitable for beginners and advanced; experience a wide range of circus skills including Rola bola, Pedalo, Unicycle, Stilts, Tight rope, Globe walking, Acrobatic and Acrobalance, Trapeze/Tissue, Hula Hoop, Juggling.

The 3-day pass entitles you to a minimum of 2 workshops per day, entry to Shows, Circus Olympics, Movies etc.
Other activities include parachute games, Circus Poster competition, Face Painting, making Juggling balls

Participant’s names:

1. Name: ________________________________________________ Age: __________

2. Name: ________________________________________________ Age: __________

3. Name: ________________________________________________ Age: __________

4. Name: ________________________________________________ Age: __________


Postal Address: __________________________________________________________

______________________________________________________________________


Email: ____________________________ Ph: ________________ Date: ____________


Total Payment for 3-day Festival Pass(es) at $50 per person (ages 4 +) $__________

Camping: $10 per adult/night $5 per child/night - no charge for under 3s.
This must be booked and paid for when registering for the festival.

Arrival date: ____________________________ Departure Date: _____________

Number of adults: _________for _________nights

Number of children: _________for _________nights

Total payment for camping: $_________

Grand total of workshop fees and camping fees) $______________

Payment by your preferred method): Internet banking: Yes / No. Cheque: Yes / No

Internet Banking for direct payments to: Kumarani Productions
To Account Number: 12 3098 0268403 00
Reference: Your Name
And: Please return this completed application to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or Circus Kumarani, 14 Parenga Street, Dargaville 0310, Northland, New Zealand

Or cheque: to the value of $_______ Please print out this form and post with payment to Circus Kumarani, 14 Parenga Street, Dargaville 0310, Northland, New Zealand

Would you like a receipt mailed to you? Yes / No

Disclaimer:
The Kai Iwi lakes are a natural environment which contains a number of hazards. The organizers wish to point out under no circumstances should children be allowed to play unsupervised in or near the lakes. Kumarani Productions t/a Circus Kumarani, and all of its staff and agents will accept no responsibility for any accidents of any kind which might occur during a workshop and throughout the festival. Children under the age of 14 years must be supervised by an adult. All participants enter at their own risk.

Please sign here to accept disclaimer for all participants registered above: _________________________________

The Fine Print:
All Weekend Pass payments must be made in advance; sorry no refund policy applies.The organiser reserves the right to change workshops and schedules

Do’s and Don’ts

CAMPING FEES

(all camping has to be booked/paid for when registering for the Festival)

Camping is limited to 150 people, be quick and register early

$ 10 per Adult/night

$ 5 per child/night 3 – 14 (no charge under 3s)

IMPORTANT

• Bookings are made per person not per campsite
• You are required to make a booking at all times
• Payment is required in FULL within 14 days of your booking date

Please note: there will be no refunds issued for any part of your stay at the Kai iwi Lakes. This includes change of numbers, early departures or non arrival.

Pine Beach

• Cold water showers
• Flush Toilets
• 2 free gas BBQ’s
• No electricity or kitchen facilities
• Small shop on site - bread, milk, takeaways, ice etc

TAHAROA DOMAIN CAMP RULES

Dogs No dogs allowed under any circumstance

Noise No noise after 10.30pm. This includes radio and musical Instruments

Firearms No firearms of any type including air gun

Fires No fires to be lit on the ground (this includes braziers)

Washing No washing of clothing in the lakes

Waste All SOLID waste and rubbish to be wrapped and placed in bins.

All LIQUID waste is to be disposed of in water sumps

Drainage Trenches to be dug if necessary and must be filled in later

Flora All plant life in the Domain is protected

Hours Gates will be locked at 9.30pm and re open at 7.30am

Generators/ Permission must be requested and only in special

Marquees circumstances will these be allowed.