Summer 2008 Registration Form

Summer 2008 Registration Form

Date______________________________________


Student's Name____________________________________________________


Address___________________________________________________________


City_____________________________ State___________ Zip____________


Birthdate __________________ Age_________ Grade_____ 


School____________________________________________________________


Circle One:     New       Returning


Previous/Requested Instructor_______________________________________________


Parent/Guardian Name __________________________Home Phone___________________


Email Address _______________________________Work Phone______________________


Instrument/Voice part _____________________________


Prior Experience____________________________________________________________



Camp/Workshop Name        Instructor               Tuition


______________________________ ________________________ $_____________


______________________________ ________________________ $_____________


Registration Fee $25.00 per person (Waived before 4/15) $_____________


Materials Fees (if applicable)                          $_____________


* Full tuition and all fees are due upon 
  registration.  
                                                  TOTAL $_____________


Method of Payment 

Check    Cash    Visa    MasterCard    Discover    American Express


I authorize the UD Department of Music to charge account number: 

________________________________________________________________


Expiration_________  Total amount to be charged_________


Print Name as on Card___________________________________________________________


Signature____________________________________ Date______________________________


Makeups cannot be given for lessons, classes or camps missed by the student without 
proper notice. I understand and accept the conditions of registration described in the 
catalog.


Signature ___________________________________________________________________



FOR JAZZ, WIND ENSEMBLE, AND MIDDLE SCHOOL BAND CAMP ONLY:


Do you study privately? Yes   No             Number of Years? ______


Name of private teacher______________________________________


Please list dates and names of any All-State or All-County Ensembles in which 

you have performed.__________________________________________________________


To be answered by your teacher: On a scale of I to VI, which grade level describes the 

student's technical performance most accurately? ______


Please have the following statement signed by your band director/private teacher: 

I recommend this student for the UD BAND CAMP __________________________________________




FOR HIGH SCHOOL CHORAL CAMP and CHILDREN'S CHOIR ONLY:


Do you study privately? Yes   No            Number of Years? ______


Name of private teacher______________________________________


Please list dates and names of any All-State or All-County Ensembles in which 

you have performed.__________________________________


To be answered by your teacher: On a scale of I to VI, which grade level describes the 

student's technical performance most accurately? ______


Please have the following statement signed by your choral director/private teacher: 

I recommend this student for the UD CHORAL CAMPS ____________________________________________



FOR BOB BECKER RAGTIME INSTITUTE ONLY AND HIGH SCHOOL CHORAL CAMP:


Will you require dorm housing? __________________


When will you be checking in? __________________ Date and Time


When will you be checking out? _________________ Date and Time