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Fauquier Strings Camp Registration 2021
Please complete this form to register for Fauquier Strings Camp 2021! If you have not done so, please also send in your payment of$100 via PayPal or mail to "Falcon Music Organization, Attn: Fauquier Strings Camp, PO Box 255, Warrenton, VA 20188." Visit
https://www.fauquiermusic.net/middle-school-orchestra-camp
for more information.
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* Indicates required question
Participant Information
First name (as it will appear in a concert program)
*
Your answer
Last name
*
Your answer
Age
*
Your answer
Participant's preferred pronouns
He/Him
She/Her
They/Them
Other:
Clear selection
Home Address (Street, City, State, Zip)
*
Your answer
Current middle school:
*
Auburn MS
Cedar Lee MS
Marshall MS
Taylor MS
Warrenton MS
Instrument:
*
Violin
Viola
Cello
Bass
Current Grade (2020-2021 School Year)
*
6
7
8
Years of playing
*
1
2
3
4+
Currently taking private lessons?
*
Yes
No
If yes, teacher's name:
Your answer
T-shirt size:
*
S
M
L
XL
XXL
Other:
Parent/Guardian Contact Information
Parent/Guardian name
*
Your answer
Relationship to student
*
Your answer
Email address
*
Your answer
Primary phone number (to be used during camp hours)
*
Your answer
Secondary phone number
Your answer
Home address (Street, City, State, Zip)
*
Your answer
Work location and phone number (if applicable)
Your answer
Please fill in the above information for a second parent/guardian, if applicable
Your answer
Emergency Contact
This person should be a non-parent/guardian (such as a grandparent, trusted neighbor, etc) who can be reached in case the primary contact is unavailable during emergencies.
Emergency Contact Name
*
Your answer
Emergency Contact relationship to student
*
Your answer
Emergency Contact phone number
*
Your answer
Medical Information
Doctor's name and phone number
*
Your answer
Please list any known allergies (food, stings, medications, etc.) and relevant health concerns, and their severity
*
Your answer
Please list any history of serious illness or injuries, with date of occurrence
*
Your answer
Please provide any other medical information that may be important (use of EpiPen, daily medications, etc.)
Your answer
I give permission for my child to participate in all activities of the Fauquier Middle School Strings Camp, held at Fauquier High School from June 14-17, 2021. I give prior permission for emergency treatment for my child in the event of an emergency. (please type your name below to sign)
*
Your answer
Thank you for registering for the Fauquier Strings Camp! If you haven't done so already, please submit your payment to finalize your registration. Please reach out to the Camp Director, Laura O'Konski (
laura.o'konski@fcps1.org
) with any questions.
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