Music Camp Registration

June 15-22, 2013

Please complete the following form. Submitting this registration form requires a non-refundable $50 registration fee to be paid by credit card.  

Registration deadline: May 15, 2013

First Name *
Last Name *
Email Address *
Phone Number *
Sex
Grade (Fall 2012) *
Parent's Names *
School Name *
School Address *
Roommate Preference
T-shirt size *
Years participated in band
Years participated in choir
Years participated in piano
Other (Specify)
Do you take private lessons?
If so, what instrument(s)?
For how long have you taken private lessons?
Please check no more than five elective interests.
Please list interests in order by preference. *
Name of teacher who endorses your application. *
Emergency Contact *
Phone Number *

A $50.00 fee is required (online payments only please)


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