2017 Crimson Jazz & Improvisation Camp Online Individual Registration Form
The following questions are to be completed by a PARENT or LEGAL GUARDIAN ONLY! All contact information MUST belong to the PARENT or LEGAL GUARDIAN. All communication regarding registration, payment, schedules, announcements, etc. from this point forward will be sent to the email address provided below.
Email address
Student's First Name
Your answer
Student's Last Name
Your answer
Student's Sex
Student's Age
Your answer
Parent/Legal Guardian's First Name
Your answer
Parent/Legal Guardian's Last Name
Your answer
Confirm Parent/Legal Guardian Email
Must match the Email Address used at the top of this form and MUST be the parent or legal guardian email.
Your answer
Parent/Legal Guardian Cell Phone
Please list Parent/Legal Guardian's cell phone as follows: XXX.XXX.XXXX
Your answer
Address - Line 1
Your answer
Address - Line 2
Your answer
City
Your answer
State
Zip Code
Your answer
Student's T-shirt Size (adult size t-shirts)
Current High School
Please list Current High School as follows: Northport High School
Your answer
Band Director's Name
Your answer
What grade level will your student complete this spring?
Please select the grade level that your student will have completed in May of this year.
What instrument do you play?
Will your student be a Resident Camper or Commuter Camper?
Resident Camper = Campus Housing Needed Commuter Camper = NO Campus Housing Needed
Roommate Request
Do you have someone you wish to room with if you will be a Resident Camper...a friend, class mate, etc.? If so, please list their name below. (List only one person)
Your answer
Jazz and Improvisation Camp Registration deadline is FRIDAY, MAY 19, 2017, 11:00 PM CST.
Please feel free to contact us at anytime should you have questions about our Crimson Music Camps.

Heath Nails
UA Band Program Assistant
Associate Crimson Music Camp/Leadership Institute Coordinator
205.348.6068
jhnails@ua.edu

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