Music Department

Camper's Name:

Email (Please PRINT):

Parent(s) Name(s):

Home Address (City, State, Zip):

Home Telephone #:

Parent Work Phone:

Camper's Cell Phone:

Instrument/Voice you play in the Improv Camp:

Grade in School as of September, 2013:

Name and Address of your school:

School Music Participation (groups, activities, etc.):

Improv Background (describe):

School Music Teacher(s):

Have you attended the Music Improv Camp before? If so, when?

Detailed scholarship and tuition information will follow.