UMSL Jazz Camp Registration
Name *
Your answer
Parent Name (if under 18)
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age (at time of camp) *
Your answer
Gender *
Address *
Your answer
City, State, Zip *
Your answer
Parent Email *
Your answer
Student Email *
Your answer
Phone Number *
Your answer
Instrument *
Your answer
Grade (2018-19) *
Your answer
School *
Your answer
Band Director *
Your answer
T-Shirt Size (adult) *
Do you plan to stay in the UMSL dorms for the week? *
Comments:
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