String Camp 2022 Registration – Homeschool Strings

RM_Stats

Info
Quantity
STUDENT 1 OF 6
STUDENT 2 OF 6
STUDENT 3 OF 6
STUDENT 4 OF 6
STUDENT 5 OF 6
STUDENT 6 OF 6
SIGNATURES AND AGREEMENTS
PAYMENT

Email^*

Parent First Name^*

Parent Last Name^*

Over Age 13 Verification^*

Person registering certifies that he/she is over the age of 13

Address

Home Phone

Please fill out at least one of the three options.

Cellular Number

Please fill out at least one of the three options.

Other Phone Number

Please fill out at least one of the three options.

Emergency Contact Information

Contact Name^*

Contact Relationship^*

Contact Phone^*

Number of Students^*

Number of Students (used for calculation)^*

Insert a numerical value ranging 1-6

Note: When you are finished entering students, leave the following pages blank and click “next” until you arrive at the “Signatures and Agreements” page. There are a total of 6 pages for student information.

Student 1 First Name^*

Input 1st student information, or your own information if self-registering

Student 1 Last Name^*

Student 1 Birthdate^*

Click on the fields in the drop down calendar to edit. Keyboard entry does not work on this field type.

Student 1 Email

Used for Class Assignments & Homework

Student 1 Instrument(s)^*

Add

Delete

Instruments student has musical experience with. Include all instruments (e.g. piano, strings, and woodwinds). Insert "none" if student has not yet played an instrument - welcome!

Student 1 Experience^*

Add

Delete

Years of experience for each instrument listed above. For example, instrument A, should go in experience field A.

Student 1 Returning^*

Check "Yes" if student has participated in Homeschool Strings in the past.

Student 1 Additional Information

You may skip this page if finished entering student information.

Student 2 First Name

Student 2 Last Name

Student 2 Birthdate

Student 2 Email

Used for Class Assignments & Homework

Student 2 Instrument(s)

Add

Delete

Instruments student has musical experience with. Include all instruments (e.g. piano, strings, and woodwinds). Insert "none" if student has not yet played an instrument - welcome!

Student 2 Experience

Add

Delete

Years of experience for each instrument listed above. For example, instrument A, should go in experience field A.

Student 2 Returning

Check "Yes" if student has participated in Homeschool Strings in the past.

Student 2 Additional Information

You may skip this page if finished entering student information.

Student 3 First Name

Student 3 Last Name

Student 3 Birthdate

Student 3 Email

Student 3 Instrument(s)

Add

Delete

Instruments student has musical experience with. Include all instruments (e.g. piano, strings, and woodwinds). Insert "none" if student has not yet played an instrument - welcome!

Student 3 Experience

Add

Delete

Years of experience for each instrument listed above. For example, instrument A should go in experience field A.

Student 3 Returning

Student 3 Additional Information

You may skip this page if finished entering student information.

Student 4 First Name

Student 4 Last Name

Student 4 Birthdate

Student 4 Email

Student 4 Instrument(s)

Add

Delete

Instruments student has musical experience with. Include all instruments (e.g. piano, strings, and woodwinds). Insert "none" if student has not yet played an instrument - welcome!

Student 4 Experience

Add

Delete

Years of experience for each instrument listed above. For example, instrument A, should go in experience field A.

Student 4 Returning

Student 4 Additional Information

You may skip this page if finished entering student information.

Student 5 First Name

Student 5 Last Name

Student 5 Birthdate

Student 5 Email

Student 5 Instrument(s)

Add

Delete

Instruments student has musical experience with. Include all instruments (e.g. piano, strings, and woodwinds). Insert "none" if student has not yet played an instrument - welcome!

Student 5 Experience

Add

Delete

Years of experience for each instrument listed above. For example, instrument A should go in experience field A.

Student 5 Returning

Student 5 Additional Information

You may skip this page if finished entering student information.

Student 6 First Name

Student 6 Last Name

Student 6 Birthdate

Student 6 Email

Student 6 Instrument(s)

Add

Delete

Instruments student has musical experience with. Include all instruments (e.g. piano, strings, and woodwinds). Insert "none" if student has not yet played an instrument - welcome!

Student 6 Experience

Add

Delete

Years of experience for each instrument listed above. For example, instrument A should go in experience field A.

Student 6 Returning

Student 6 Additional Information

CONSENT FOR MEDICAL TREATMENT: As the parent or legal guardian of the above-named child(ren), I give
my consent for emergency medical care prescribed by a fully licensed physician or dentist. This care may
be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent(s).

RELEASE OF LIABILITY: I hereby release, discharge, and/or otherwise indemnify and hold harmless Home
School Strings and its representatives from any claim, damage, cost or liability by or on behalf of the
registrant(s) as a result of participation in the Home School Strings Program at any location.

DAMAGES: I agree to be solely responsible for the instrument(s) in my child’s possession, for any maintenance and repairs of that instrument, whether owned or rented. I agree to cover the costs of repair or
replacement of an instrument damaged, destroyed or lost due to my child’s actions. I agree to cover the
replacement costs of music lost while in my child’s possession.

PHOTO/VIDEO: I give permission to Home School Strings to take and use photographs/videos of the
aforementioned children. I understand that the media will become the property of the Home School
Strings and I agree that the media may be used in multimedia presentations, videotapes, books, supplemental products, and related advertising materials, such as brochures or websites.

Handbook: My child(ren) and I have read the HSS Handbook (located here) and agree to abide by its policies.

Terms and Conditions Signature^*

Please type your name to agree to the terms and conditions laid forth above.

STUDENT CONDUCT: I understand that I am expected to have good behavior and speech at all times. I
understand that there is no running around indoors or outdoors. I may read or do homework quietly in the
sanctuary or conference room. I may eat lunch or talk quietly in the foyer or outside.

Student 1 Signature^*

Please type your name in this box to agree to the HSS student conduct

Student 2 Signature

Please type your name in this box to agree to the HSS student conduct

Student 3 Signature

Please type your name in this box to agree to the HSS student conduct

Student 4 Signature

Please type your name in this box to agree to the HSS student conduct

Student 5 Signature

Please type your name in this box to agree to the HSS student conduct

Student 6 Signature

Please type your name in this box to agree to the HSS student conduct

Note:

Select “PayPal” if you want to pay online using a credit/debit card (no PayPal account needed).

Select “Pay Offline” if you want to pay using cash, check, or another payment method. Please contact us after submitting this form if using this option.

Select a payment method^*

Pay Offline

String Camp 2024 Registration