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Replay Music Studios Camp Registration Form
Holiday and Summer Camps, 2019
Name of Student *
Your answer
Date of Birth *
Age *
Your answer
Your answer
Address *
Your answer
Name of Parent(s)/Guardian(s) *
Your answer
Parent/Guardian E-mail 1 *
Your answer
Parent/Guardian E-mail 2
Your answer
School/Grade *
Your answer
Home Phone
Your answer
Business Phone
Your answer
Parent's Cell Phone *
Your answer
Parent's Cell Phone 2
Your answer
Child's Cell Phone
Your answer
Emergency Contact/Number *
Your answer
Relationship *
Your answer
Does your child have permission to leave the studio on their own, without adult supervision? *
Does your child have any allergies *
If yes, please explain:
Your answer
Are there any other medical issues or other information we should know about your child? If yes, please explain:
Your answer
The information from the following questions about your child will be used to help us place him/her into the best possible band situation taking into account age, experience and interests:
1. Instrument(s) played:
Your answer
2. How many years have you played/had private lessons?
Your answer
3. Favorite bands and songs:
Your answer
4. Have you played in a band before?
Your answer
5. Do you sing/want to sing?
Your answer
Camp meets from 1:00 pm - 5:00 pm Monday Through Friday
Cost: $540

Start Time is 12:00 pm if adding private lessons.
Total cost with daily 1/2 hour private lesson: $740

I would like to add Private Lessons on:
My child is registering for the following week(s):
Permission To Use Child's Likeness:
I, on behalf of my child, grant Replay Music Studios and its agents and employees the right and permission to record and photograph my child, and consent to and authorize the use and reproduction by Replay Music Studios of any and all photographs, recordings, videotapes, and/or other reproductions of likenesses of my child’s person and characteristics (“reproductions”) for any purpose whatsoever that is related to the marketing of Replay Music Studios, without compensation to the student and without notification to me. All reproductions shall be the property of Replay Music Studios, solely and completely. Further, I assign and release all rights to said reproductions, and authorize Replay Music Studios, or others authorized by them, to exhibit, broadcast, and/or distribute or otherwise further reproduce said reproductions in whole or in part over or in any medium whatsoever, including, without implied limitation, newsletters, radio, newspapers, film, cable, television, and digital media, without compensation, in perpetuity.
I give permission to Replay Music Studios to use my child's likeness: *
Terms, Conditions & Cancellation Policy
I agree to pay $540 for each week of camp and $740 for each week that includes private lessons. Payment is due on or before the first day of camp. For a full refund of the enrollment fee, cancellations must be made no later than 2 weeks prior to the scheduled start date of the camp session. Cancellations made with less than 2 weeks’ notice will be given credit to another week of camp. If attendance is below 3 students, Replay has the right to cancel a session no later than 48 hours prior to the starting time with a full refund.
General Rules of the Studio
• Shirts, shoes and pants must be worn at all times.
• NO DRUGS OR ALCOHOL: REPLAY STUDIOS EXPRESSLY PROHIBITS the possession, sale, or use of any illegal substances on the premises. Possession or consumption of alcoholic beverages on the premises is prohibited. violation of this condition will get you thrown out and it is not up for discussion or debate.
• NO FOOD is allowed in the rooms. Non-alcoholic beverages are allowed in the rooms provided the beverage is in a sealed container (plastic bottles w/ screw-on lids, travel mugs, etc., No Glass containers) which must remain sealed when not in use
• Our spaces are for rehearsal, recording, and creativity ONLY. Please do not engage in any activity that may damage or destroy the equipment.
• Computer use in the studios is reserved for music and music related resources and to be used ONLY with a teacher. Students are not allowed to search the Internet (Youtube) without express permission/supervision of a teacher.
• Use of the following equipment is included in the class unless otherwise specified above:
(1) 5-piece drum kit, cymbals and accessories
(3) Three guitar amplifiers
(1) One bass guitar amplifier
(1) One P.A. > 2 speakers, 2 floor monitors, one mixing board, 4 power amplifiers.
(1) Keyboard
(1) Computer, monitor, mouse and keyboard for recording
Any necessary microphones, cables and stands.

• REPLAY STUDIOS is not responsible for the loss or damage of misplaced or unsupervised personal goods. Please take care of your belongings, and be respectful of everyone else’s belongings.

• At REPLAY STUDIOS we believe in working cooperatively in order to achieve the best results. All Members are expected to respect each other and respect the Band Coaches/staff.

I have read and understand the terms and conditions for registering for Camp and agree to the Pricing, Cancelation and Make-up Policies, and General Rules of the Studio. *
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