Rock Band Camp Registration - Jacksonville School of Music

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ROCK BAND CAMP REGISTRATION

Camper's Information

* Indicates required field

Child's Name *

First

Last

Child's Age *

Child's Gender *

Has child had prior musical experience singing or playing an instrument? *

If "Yes", vocal, drums, guitar, bass, or keyboard? *

How long? *

Does the child have any special needs? *

If "Yes", please explain: *

The Camp Director will contact you to discuss and confirm that we are able and equipped to handle your child's special needs.

Does your child have any known allergies? *

If "Yes", please specify: *

Parent/Guardian Information

Parent/Guardian Name *

First

Last

Parent/Guardian Name - 2nd Contact *

First

Last

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Email *

Email - 2nd Contact *

Phone Number *

Alt. Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Is anybody else authorized to pick up your child? *

If "Yes", please list the name(s) AND phone number(s) of those who are authorized: *

Preferences

Please indicate which role your student would prefer in the rock band, with "1" being their first choice and "5" being their last choice.
* Note: Listing preferences below does not mean that campers will have their first choice of instrument/vocal in the final showcase. However, campers will have the opportunity to gain exposure to more than one instrument throughout the week.

Vocal *

1 2 3 4 5

Guitar *

1 2 3 4 5

Bass *

1 2 3 4 5

Drums *

1 2 3 4 5

Keyboard *

1 2 3 4 5

Will your child need extended day care? (Extended day care is available for early drop-off or late pick-up. $10 per half hour. Advanced notice is required [prior day for early drop-off, same day for late pick-up]). *

Early Drop-Off Late Pick-Up Not Needed

How/where did you hear about our camp? *

Submit

Location

What Our Clients Are Saying

"The BEST music school ever!!!!! The kids truly enjoy coming to learn new songs and techniques. Outstanding teachers and staff!!!"

- Ted Santos

"Best music school and teachers in Jacksonville!!!!"

- Patterson Family

"Both of my children have taken lessons at the Jacksonville School of Music. The teachers and staff are fabulous!!!!"

- Christie Lauderdale

Home
About
Summer Music Camp
Recital
Contact
Careers