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Northwest Summer
MUSIC CAMP Registration
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The registration deadline is May 15th, 2023. Please note that a $150.00 deposit is required by May 22nd (checks payable to NWC Music Camp). If you received a scholarship during the Showalter Music Festival, please note that below (including amount) and bring your certificate to registration on the first day of camp to receive your discount.
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
Would you like to purchase lunch tickets for the week of camp? ($45 for 5 lunches in the NWC Dining Hall - this amount will be added to your camp registration total).
*
Yes
No
Camp T-Shirt Size
*
Small
Medium
Large
X-Large
XX-Large
Tell us your primary instrument or if you are a vocalist:
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 am not sure
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 2023 should select Junior High Band or Choir. Students entering grades 9 and above in Fall 2023 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
*
High School Jazz Choir
Junior High Jazz Band
Fun & Fitness
Chess
Boom Whackers
Percussion Ensemble
Beginning Guitar
11 AM SECOND CHOICE
*
High School Jazz Choir
Junior High Jazz Band
Fun & Fitness
Chess
Boom Whackers
Percussion Ensemble
Beginning Guitar
11 AM THIRD CHOICE
*
High School Jazz Choir
Junior High Jazz Band
Fun & Fitness
Chess
Boom Whackers
Percussion Ensemble
Beginning Guitar
2 PM FIRST CHOICE
*
High School Jazz Band
Junior High Jazz Choir
Fun & Fitness
Chess
Boom Whackers
Music Tech/DJ
Beginning Guitar
2 PM SECOND CHOICE
*
High School Jazz Band
Junior High Jazz Choir
Fun & Fitness
Chess
Boom Whackers
Music Tech/DJ
Beginning Guitar
2 PM THIRD CHOICE
*
High School Jazz Band
Junior High Jazz Choir
Fun & Fitness
Chess
Boom Whackers
Music Tech/DJ
Beginning Guitar
4 PM FIRST CHOICE
*
Chamber Music Ensembles
Fun & Fitness
Frisbee Golf
Chess
Drum Circle
Music Tech/DJ
4 PM SECOND CHOICE
*
Chamber Music Ensembles
Fun & Fitness
Frisbee Golf
Chess
Drum Circle
Music Tech/DJ
4 PM THIRD CHOICE
*
Chamber Music Ensembles
Fun & Fitness
Frisbee Golf
Chess
Drum Circle
Music Tech/DJ
Parent/Guardian Information
Name(s)
*
Home Phone
*
Cell Phone
Alternate Phone
Email
*
Emergency Contact Info
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 named 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