Registration Form 2022
NOTE: Be sure to continue to PayPal to complete registration after you have clicked on the "submit" button at the bottom of this form!

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Student's First Name *
Student's Last Name *
Parent Name(s) *
Address: Street *
Address: City *
Address: Zip Code *
Parent e-mail address *
Preferred Phone *
xxx-xxx-xxxx
Secondary Phone
Additional Phone
Medical Information:  (please list any medical concerns of which we should be aware)
Emergency Contact Name and Number (optional)
Student's current school *
School student will attend next fall *
Grade next fall *
Level of band your child is in this year. (2021/22) *
Instrument *
Honors earned this year
(made Region Band, solo, etc)
Gender *
Camp T-Shirt *
select child's t-shirt size (100% cotton)
Emergency Medical Release and Waiver of Liability *
I hereby authorize the staff of the Stars and Stripes Band Camp to act for me in accordance with their judgment in any emergency requiring medical attention. I further waive and release Stars and Stripes Band Camp from liability for any damages from injuries and/or illness sustained at the Stars and Stripes Band Camp. I know of no mental or physical conditions that might affect my child’s ability to safely participate in the camp.
Photography
Please be aware that we will be taking pictures throughout the week to use for a camp slide show.  Some of these pictures may be posted on the camp web site.  A video recording will be made of camp performances. Some of these performances may also be used on the internet for promotional purposes and will be made available for purchase on a commemorative DVD.
How did you hear about this camp?
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Registration Fee
Please use the PayPal link to submit payment for camp. You will immediately receive a receipt from PayPal. Your child is not officially enrolled until you have received a receipt of payment from PayPal.

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