Pioneer Orchestra Camp Registration Form - 2019
Welcome Pioneer Orchestra Community!

We are thrilled that you have decided to attend camp this August 6-12, 2019. Attending Pioneer Orchestra Camp is a great way for a new student to get to know students from every grade and ensemble, in an environment that is nurturing, supportive, and challenging. Returning students have the chance to renew old friendships and develop new ones!

Registration for Pioneer Orchestra Camp 2019 runs from April 15- May 15. Registration closes on May 15, 2019, though when at capacity, the registration may be closed early.

To register, you must do the following:
Step 1. Read camp Bulletin #1, found on www.phsorchestra.com
Step 2. Complete this Google Doc.
Step 3. Submit payment in full ($405), partial ($200), or contact Mr. Glawe to arrange a payment plan. Checks payable to "POPS". Deadline: May 15th

Step 4. Complete the following forms:

a. District Camp Health Form  DOCTOR SIGNATURE REQUIRED
b. AAPS Parent Notification and Consent Form
c. Submit a photocopy of BOTH sides of your health insurance card. OR complete the Non- Insured Form.
If you have a food allergy, please submit the Food Allergy Plan Form.

All documents should be sent to the mailing address below or dropped off at Pioneer.

Jonathan Glawe
2018 Orchestra Camp Registration
Pioneer High School
601 W. Stadium Blvd
Ann Arbor, MI 48103

Registration closes on May 15, 2019, though when at capacity, the registration may be closed early.

Go Purple! Go White!
Mr. Glawe

Student Last Name *
Your answer
Student First Name *
Your answer
Graduation Class of ____? *
Camp T-Shirt Size *
Student’s gender identity is:______________________ *
Cabin Gender Preference *
Cabins are determined based on comfortability of all students. Our standard practice is to assign cabins according to a students' consistently asserted gender identity. If you have any questions regarding cabin assignments, please contact the director.
Donation to Camp Scholarship Fund------ If you wish to make a donation to support other orchestra students in financial need, please indicate the amount of your donation in the box below. Please attach a separate check, payable to the Pioneer Orchestras Parents Society, and indicate "Donation" in the subject line.
Your answer
Primary Camp Instrument *
Family E-mail Address #1 *
Your answer
Family E-mail Address #2
Your answer
Student E-mail Address *
Your answer
Parent/Guardian Name(s) (first & last) *
Your answer
Street Address *
Your answer
Zip Code *
Your answer
Family phone XXX-XXX-XXXX *
Your answer
Student Cell Phone XXX-XXX-XXXX
optional
Your answer
Will you be riding to camp on the bus? (recommended) *
Will you be riding from camp on the bus? (recommended) *
Mentor Information *
I am interested in being considered for a section leader position at camp. *
I understand that the total fee for Orchestra Camp is $405.00. Choose from the following options: *
Is there anything else you would like me to know in order to make your camp experience a positive one?
Your answer
Student Signature *
I understand that in applying for membership to the Pioneer Orchestra Camp, I agree to conform to all rules of the Interlochen Center for the Arts and Pioneer High School as detailed in Orchestra Camp Bulletin No. 1.
Your answer
Parent/Guardian Signature *
I understand that in applying for membership to the Pioneer Orchestra Camp, my son/daughter agrees to conform to all rules of the Interlochen Center for the Arts and Pioneer High School as detailed in Orchestra Camp Bulletin No. 1.
Your answer
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