MUSIC WORKS Summer Camp Registration Form 2015

This one-week camp provides a fun and unique music education experience for rising 7th-9th grade students. Student musicians will develop music literacy, performance technique, and musicianship in both a full band setting and small group sectionals. Campers may also register for a private lesson with a high school or college student for an additional $15. The week concludes with a free performance for family and friends on the final day of camp.

MUSIC WORKS is held in the performing arts wing of

Central Academy of Technology & Arts

600 Brewer Drive, Monroe NC 28112

June 15-18, 2015

9am - 4pm

Camp tuition $100

Tell us about your camper!

First Name *

Last Name *

Preferred Name/Nickname

Gender *

Middle School *

Grade Just Completed *

Primary Instrument *

Number of years in band *

T-Shirt Size *

Help us keep your camper healthy!

Physician Name *

Physician Phone *

Allergies

Medication

Reason for Medication

Special needs we should know about to help your camper have a fantastic experience (physical, mental, social, behavioral, or emotional)

Parent Name and Contact Information

First Name *

Last Name *

Relationship to Camper *

Email Address *

Confirm Email Address *

Address and Phone

Address 1 *

Address 2

City *

State *

Zip *

Phone 1

Phone Type *

Phone 2

Phone Type *

Emergency Contact

Name *

Phone Number *

Relationship to Camper *

Method of Payment

Camp tuition may be paid via check or Paypal.

Checks should be mailed with a camp tuition payment voucher (avaiable online at www.cataband.blogspot.com) to CATA Band Boosters at 600 Brewer Drive Monroe, NC 28112.

Paypal payments can be made by vistiing the CATA Band website and clicking on the Paypal button in the top left hand corner - www.cataband.blogspot.com *