March Break Jazz Camp Application
Please Fill out the following to apply for the HMC's March break big band Camp
Email address *
Last Name of Student *
Your answer
First Name of Student *
Your answer
Last Name of Parent / Guardian *
Your answer
First name of Parent / Guardian *
Your answer
Age of Student *
Your answer
Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Student Phone Number *
Your answer
Contact Phone Number *
Your answer
What instrument do you play? *
Your answer
How many years have you been playing your instrument? *
School *
Your answer
Band Director *
Your answer
Are there any medical concerns or anything we should know about? If yes, please describe below
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Would you like to be added to the Halifax Music Co-op mailing list to receive information about HMC events, concerts, and other Marketing? *
Acknowledgement
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