Name_____________________________________Grade________Age______
Address______________________________________________City_______________State___________Zip________
Parent(s) Name_____________________________________Phone Number___________Home_______Work_______
Computer 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 workshop hours are 9:00 A.M. until 1:00 P.M., Monday through Thursday. Usually distance attendees arrive on Sunday evening and leave on Thursday afternoon. The Music Technology Workshop is not responsible for attendees during non-camp time. All attendees 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 Music Technology Workshop. I have
discussed with my child that he or she is expected to act with the best conduct at all
times and that the Workshop 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 the workshop.
The cost of the workshop is $150.00. Cumberland University does not provide food, lodging, or transportation.
See: Accommodations and Directions for out of area attendees.
Enclose $25.00 deposit with this form and mail ASAP to: Music
Technology Workshop, Attn: Glenn Martin-Director,
3223 Brookwood Ln, Lebanon, TN 37087.
If you have any questions, please email Glenn Martin
Link to Summer Jazz Camp
return to:
Music Technology Workshop Webpage
.