Bemidji MusiCamp Registration Form
July 21 - 27, 2019

Mailing Address:
Bemidji MusiCamp
PO Box 816
Bemidji, MN 56619-0816

website: bemidjimusicamp.org
email: info@bemidjimusicamp.org
phone: (612) 470-2267

Part I: Camper Information
Last Name *
Your answer
First Name *
Your answer
Middle Initial
Your answer
Grade in School *
In Fall 2019
Age *
on July 21, 2019
Date of Birth *
MM
/
DD
/
YYYY
Gender *
T-Shirt *
Adult Size
Home Address *
Your answer
City *
Your answer
State *
Abbreviation (example: MN)
Your answer
Zip Code *
Your answer
Parent/Guardian Name(s) *
Your answer
Parent/Guardian Phone Number *
(xxx) xxx-xxxx
Your answer
Parent/Guardian Email Address *
Your answer
Student Cell Phone Number *
(xxx) xxx-xxxx
Your answer
Student Email Address *
Your answer
Music Teacher's Name(s) *
Your answer
School Name *
Your answer
School Location *
City, State
Your answer
How did you hear about Bemidji MusiCamp? *
Your answer
Have you attended Bemidji MusiCamp previously? *
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