Registration Form 2020
NOTE: Be sure to scroll all the way down until you click the "submit" button at the bottom of the registration form;
the last question is "How do you plan to pay?" If you do not receive a pop up that says "Stars and Stripes received your data," then your registration form did not get sent.
Student's First Name *
Your answer
Student's Last Name *
Your answer
Parent Name(s) *
Your answer
Address: Street *
Your answer
Address: City *
Your answer
Address: Zip Code *
Your answer
Parent e-mail address *
Your answer
Preferred Phone *
Your answer
Secondary Phone
Your answer
Additional Phone
Your answer
Medical Information: (please list any medical concerns of which we should be aware)
Your answer
Emergency Contact Name and Number (optional)
Your answer
Student's current school *
Your answer
School student will attend next fall *
Your answer
Grade next fall *
Level of band your child is in this year. (2019/20) *
Instrument *
Honors earned this year
(made Region Band, solo, etc)
Your answer
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.
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?
How do you plan to pay? *
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