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Northwest Summer
MUSIC CAMP Registration
Please enable JavaScript in your browser to complete this form.
Camper Name
*
First
Last
Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
Phone
*
For use by counselors when at camp.
School Last Attended
*
example: Powell Middle School
Grade You Will Enter in Fall of 2023
*
Numbers only
Gender
*
Male
Female
Are You A Overnight Camper?
Yes
No
If Overnight Camper, You May List One Roommate Request
First
Last
Do you plan to attend the Cody Recreation Center Trip on Wednesday, June 24? (There is an additional cost of $5 for Commuting Campers).
*
Yes
No
On the evening of the Cody REC trip, Commuting Campers may eat dinner in the NWC Dining Hall for an additional cost of $9. Please indicate if you will be eating in the NWC Dining Hall on Wednesday, June 24.
*
Yes
No
Would you like to purchase lunch tickets for the week of camp? ($40 for 5 lunches in the NWC Dining Hall - this amount will be added to your camp registration total).
*
Yes
No
Camp T-Shirt Size (Please note: these are ADULT sizes only. We CANNOT guarantee t-shirts for students registering after June 1st!)
*
Small
Medium
Large
X-Large
XX-Large
If there are other instruments you play and would be interested in playing at camp, please list them here:
Voice Type
*
Soprano
Alto
Tenor
Bass
I do NOT plan to sing at camp
CLASS SELECTION
Please select the main group that you will attend, and then select your first, second, and third choice for the classes you would like to take during the "elective" hours (11 AM, 2 PM, and 4 PM).
Which main group will you attend? Students entering grades 6-8 in Fall 2020 should select Junior High Band or Choir. Students entering grades 9 and above in Fall 2020 should select High School Band or Choir. Piano players who do not have at least a year of experience on another instrument MUST register as Choir Campers. These students may sign up for piano lessons or take piano class, but they must attend as Choir Campers.
*
High School Band
High School Choir
Junior High Band
Junior High Choir
11 AM FIRST CHOICE
*
Beginning Instrument
Chess
Drum Circle
Fun and Fitness
HS Jazz Band
JH Jazz Choir
Piano Class
11 AM SECOND CHOICE
*
Beginning Instrument
Chess
Drum Circle
Fun and Fitness
HS Jazz Band
JH Jazz Choir
Piano Class
11 AM THIRD CHOICE
*
Beginning Instrument
Chess
Drum Circle
Fun and Fitness
HS Jazz Band
JH Jazz Choir
Piano Class
2 PM FIRST CHOICE
*
Beginning Guitar
College Orientation (HS Only)
Fun and Fitness
Graphic Arts
HS Jazz Choir
Jazz Piano
JH Jazz Combo
JH Studio Recording
Percussion Ensemble (HS Only)
2 PM SECOND CHOICE
*
Beginning Guitar
College Orientation (HS Only)
Fun and Fitness
Graphic Arts
HS Jazz Choir
Jazz Piano
JH Jazz Combo
JH Studio Recording
Percussion Ensemble (HS Only)
2 PM THIRD CHOICE
*
Beginning Guitar
College Orientation (HS Only)
Fun and Fitness
Graphic Arts
HS Jazz Choir
Jazz Piano
JH Jazz Combo
JH Studio Recording
Percussion Ensemble (HS Only)
4 PM FIRST CHOICE
*
Beginning Guitar
Boomwhackers
Brass Ensemble
Graphic Arts
HS Jazz Combo
HS Studio Recording
JH Jazz Band
Musical Theater
Percussion Ensemble (HS Only)
4 PM SECOND CHOICE
*
Beginning Guitar
Boomwhackers (JH Only)
Brass Ensemble
Graphic Arts
HS Jazz Combo
HS Studio Recording
JH Jazz Band
Musical Theater
4 PM THIRD CHOICE
*
Beginning Guitar
Boomwhackers (JH Only)
Brass Ensemble
Graphic Arts
HS Jazz Combo
HS Studio Recording
JH Jazz Band
Musical Theater
Parent/ Guardian Information
Default will be Parent/Guardian if this section is left blank.
Home Phone
*
Cell Phone
Alternate Phone
Email
*
Emergency Divider
Emergency Contact Name
*
First
Last
Relationship
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Other
Emergency Phone
Alternate Emergency Phone
Does the camper have any allergies, chronic illness, or medical conditions of which the camp counselors should be aware? If yes, please describe. Please send along any prescription drugs which may be needed.
Informed Consent and Acknowledgement
I, the undersigned, hereby authorize Yellowstone Summer Music Camp officials to act for me according to their judgement in any emergency requiring medical attention for the student named above, if camp officials are unable to contact me. He/She also has my permission to participate in all camp activities. I give my consent for administration of cough drops, Ibuprofen or Tylenol, and Tums as needed.
I grant to Northwest College (photographer) and its legal representatives and assigns, the irrevocable and unrestricted right to use and publish photographs/videos of the minor names above, or in which the minor may be included, for editorial, tradee, advertising and any other purpose and in any manner and medium; to alter the same without restriction; and to copyright the same. I release Northwest College (photographer) and its legal representatives and assigns from all claims and liability relating to said photographs/videos.
Confirmation
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature
*
Clear Signature
Date
*
Submit