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About
Gem State Jazz Camp
Gem State Jazz Camp Registration
Camp Payment Page
Media & Liability Release Form
Lesson Packages
6-Lesson Trial Packages
12-Lesson Packages
24-Lesson Packages
48-Lesson Packages
Education
Lesson Inquiry
Teacher Bios
Educator Resources
>
LPX - Score Editor
LPX - Basics
Student Resources
Blog
Arranging, Scoring, and More
Scoring, Engraving, Sound Demos
Composing, Arranging, Orchestration, Production
Main
Contact
About
Gem State Jazz Camp
Gem State Jazz Camp Registration
Camp Payment Page
Media & Liability Release Form
Lesson Packages
6-Lesson Trial Packages
12-Lesson Packages
24-Lesson Packages
48-Lesson Packages
Education
Lesson Inquiry
Teacher Bios
Educator Resources
>
LPX - Score Editor
LPX - Basics
Student Resources
Blog
Arranging, Scoring, and More
Scoring, Engraving, Sound Demos
Composing, Arranging, Orchestration, Production
Gem State Jazz Camp Registration Form
*
Indicates required field
Parent/Guardian Name
*
First
Last
Parent/Guardian Email
*
Parent/Guardian Phone
*
Mailing Address
*
Line 1
Line 2
City
State
Zip Code
Country
Note: In case of emergency, the parent/guardian will be contacted first. Please provide an
additional
contact in the event the parent/guardian is not reachable.
Emergency Contact Info:
*
First
Last
Please enter an additional, different contact for emergency purposes.
Emergency Phone
*
Text-Enabled Cell Phone
Emergency Email
*
Which camp are you interested in joining?
*
Middle School (entering grades 7-9)
High School (9-12th Grades)
Both! (entering 9th Grade)
The Middle School camp is for students entering
7th through 9th
grades.
The High School camp is for students entering
9th through 12th
grades.
Students entering 9th grade can join both camps for 10% off the total package!
Student Profile Information
Let us know about our incoming student - Please fill out a new form for each student if you have multiple joining us.
Student Name
*
First
Last
Instrument
*
Piano
Bass
Guitar
Drum Set (Percussion)
Trumpet
Alto Saxophone
Tenor Saxophone
Baritone Saxophone
Trombone
Other
Years Studied
*
Taken Private Lessons?
*
Yes
No
Private Teacher Name
*
First
Last
(Optional - not required)
Secondary Instrument
*
None
Piano
Bass
Guitar
Drum Set (Percussion)
Trumpet
Trombone
Alto Saxophone
Tenor Saxophone
Baritone Saxophone
Other
Years Studied
*
Current School Name
*
For the 2018/2019 School Year
Current Band/Orchestra Teacher
*
First
Last
If none, please enter your private teacher's name again
Entering which grade, this coming fall?
*
6th (Audition Required)
7th
8th
9th
10th
11th
12th
Camp T-Shirt Size
*
XS
S
M
L
XL
XXL
Based on adult sizes
Gender
*
Male
Female
Please list -all- food allergies or restrictions, and any other important physical or mental health information
*
Required - Camp photos & videos will be used in promotional and marketing materials for Gem State Jazz Camp and Exodus Music LLC
*
I agree and understand there will be a media and liability release form required to participate in the camp
Media and Liability Release Form
(opens in new window)
I agree to receiving marketing and promotional materials
*
Submit