Name_____________________________________Grade________Age______Instrument_________________________
Address______________________________________________City_______________State___________Zip________
Parent(s) Name_____________________________________Phone Number___________Home_______Work_______
Jazz Experience Level: Beginner______Intermediate______Advanced______ Email Address____________________
School___________________________Band Director or Teacher____________________Phone Number____________
School Address___________________________________City________________State___________Zip_________
Band Director Or Private Teacher Recommendation Signature_____________________________________________
The camp hours are 9:00 A.M. until 1:00 P.M., Monday through Thursday. Usually distance campers arrive on Sunday evening and leave on Thursday afternoon. The Jazz Camp is not responsible for campers during non-camp time. All campers are expected to act with their best conduct at all times. Minors who are staying in overnight accommodations should be supervised by parents, teachers, or other responsible adults.
Parents of Minors Sign Below:
I ________________________________________________________________________ hereby give
my
child______________________, permission to attend Summer Jazz Camp. I have discussed
with my child that he or she is expected to act with the best conduct at all times and
that the Camp staff reserves the right to send my child home at my expense if
they determine that he or she is acting with disruptive or improper behavior. My
son or daughter understands that no drugs or alcohol are allowed at anytime during the
camp. Date:____________________
Please list any illness or condition on back of this form that you would want us to know about and that would aid us in assisting your child at Jazz Camp.
The cost of the camp is $150.00. Cumberland University does not provide food, lodging, or transportation.
See: Accommodations and Directions for out of area campers.
Enclose $25.00 deposit with this form and mail ASAP to: Summer
Jazz Camp, Attn: Glenn Martin-Director,
3223 Brookwood Ln, Lebanon, TN 37087.
If you have any questions, please email or call: (615) 444-2570 or (615) 504-1596.
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