Bard Music Camp 2017 - Full Day Program

Application for FULL DAY PROGRAM
Monday July 3 to Saturday, July 15, 2017

* Indicates required field
Name Name First Last
Date Of Birth Date Of Birth / MM / DD YYYY
Gender
Grade in School (in Fall 2017)
School Name
PARENT/GUARDIAN INFORMATION
1. Name (Mr. Mrs. Dr. Ms.)
Cell Phone for Parent/Guardian #1 Cell Phone for Parent/Guardian #1 - ### - ### ####
Home Phone Home Phone - ### - ### ####
Email for Parent/Guardian #1
Relationship to Student
2. Name (Mr. Mrs. Dr. Ms.)
Cell Phone for Parent/Guardian #2 Cell Phone for Parent/Guardian #2 - ### - ### ####
Home Phone Home Phone - ### - ### ####
Email for Parent/Guardian #2
Relationship to Student
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Emergency contact #1 (other than parent): Emergency contact #1 (other than parent): First Last
Emergency contact #1 phone Emergency contact #1 phone - ### - ### ####
Emergency contact #2 (other than parent): Emergency contact #2 (other than parent): First Last
Emergency contact #2 phone Emergency contact #2 phone - ### - ### ####
PRIVATE INSTRUCTIONS AVAILABLE FOR:

Piano, Violin, Viola, Cello, Double Bass, Guitar, Voice, Clarinet, Saxophone, Trombone, Trumpet, Composition, Percussion
Registering for:
Primary Instrument:
Yrs of study:
Current and Previous Teacher (of primary instrument)
Secondary Instrument (please only list if studying at the Camp):
Yrs of study:
Current and Previous Teacher (of secondary instrument)
Additional Instrument (please only list if studying at the Camp):
Yrs of study:
Current and Previous Teacher (of additional instrument)
CAMP T-SHIRTS:
Please Indicate Student T-shirt size:

Please Indicate Student T-shirt size: Kids Size EXTRA SMALL Adult Size EXTRA SMALL Kids Size SMALL Adult Size SMALL Kids Size MEDIUM Adult Size MEDIUM Kids Size LARGE Adult Size LARGE Kids Size EXTRA LARGE Adult Size EXTRA LARGE
WEEK 1 FULL DAY PROGRAM AGES 5 - 9 (please check all that apply)
Monday, July 3 to Saturday, July 8, 2017

WEEK 1 FULL DAY PROGRAM AGES 5 - 9 (please check all that apply)
Monday, July 3 to Saturday, July 8, 2017 Full Day: July 3 to 8 -- $580 Secondary Instrument -- $150 Additional Instrument -- $150 Tennis Mini-Camp Tuition -- $100
WEEK 2 FULL DAY PROGRAM AGES 10 - 18 (please check all that apply)
Monday, July 10 to Saturday, July 15, 2017

WEEK 2 FULL DAY PROGRAM AGES 10 - 18 (please check all that apply)
Monday, July 10 to Saturday, July 15, 2017 Full Day: July 10 to 15 -- $580 Secondary Instrument -- $150 Additional Instrument -- $150 Tennis Mini-Camp Tuition -- $100
DISCOUNTS

DISCOUNTS 10% Bard Employee Discount (applied to tuition only; not including fees or tennis tuition)
FEES

FEES $25 Registration Fee per Family (waived for current Prep Spring 2017 students & siblings) $25 Late Fee (if Registered after June 1)
AN INVOICE AND RELEASE FORMS WILL BE EMAILED TO YOU AFTER WE RECEIVE YOUR COMPLETED REGISTRATION FORM
NOTES:

Bard Music Camp 2017 - Full Day Program

Bard Music Camp 2017 - Full Day Program

* Indicates required field

PARENT/GUARDIAN INFORMATION

PRIVATE INSTRUCTIONS AVAILABLE FOR:

Registering for:

CAMP T-SHIRTS:

AN INVOICE AND RELEASE FORMS WILL BE EMAILED TO YOU AFTER WE RECEIVE YOUR COMPLETED REGISTRATION FORM