REGISTRATION FORM:

DEADLINE: JULY 23,2010

NAME:---------------------------------------------

ADDRESS: ---------------------------------------

CITY: -----------------------------------------------

STATE:----------------------------------------------

ZIP: -----------------------------------

GRADE YOU ARE IN NOW: ---------------------
SCHOOL:

HOME PHONE:---------------------------

MOTHER'S PHONE: -----------------------

FATHER'S PHONE:--------------------------

EMAIL ADDRESS WHERE WE CAN SEND INFORMATION: -----------------------------------

WEEKS YOU WILL ATTEND CAMP: WEEK ONE----- WEEK TWO------ BOTH-----

DO YOU NEED ROOM AND BOARD?-------------------

IF SO, WHICH WEEKS: WK 1 ONLY--------- BOTH WEEKS-----------------

EMERGENCY CONTACT NUMBER: NAME--------------------------- PHONE:----------------------

WHICH INSTRUMENT DO YOU PLAY: PLEASE CIRCLE(You can circle more than one)
CLARINET, FLUTE, PICCOLO, BASSOON, ALTO SAX, BARI SAX, TENOR SAX, SOPRANO SAX, OBOE, FRENCH HORN

WHAT LEVEL DO YOU THINK YOU WOULD BE IN PLEASE CIRCLE:
BEGINNER, INTERMEDIATE, ADVANCED. REMEMBER THAT YOU CAN MOVE UP AND DOWN LEVELS ONCE YOU ARE AT THE CAMP!?

Audtions for levels beyond the beginner, will be held the first day of camp. This will include:

Intermediate: All major scales, up to four sharps and four flats, as many octaves as possible, any tempo?and aritculation. One prepared piece of your choice not more than 5 minutes.

Advanced: All major scales, chromatic and one prepared piece of music grade level 5 or 6. The prepared piece should not be more than 5 minutes in length. Scales should be prepared to your distrcit band auditions

WHAT ELECTIVE ARE YOU INTERESTED IN? MODERN DANCE, DRAMA, GUITAR..

INTERESTED IN CAR POOLING:

FULL PAYMENT IS NOT DUE UNTIL THE FIRST DAY OF CAMP.
$150. 00 NON- REFUNDABLE. Make check payable to: Judith Lapple
DEPOSIT IS DUE WITH YOUR APPLICATION. MAIL COMPLETED REGISTRATION FORM WITH 150.00 DEPOSIT TO:
JUDITH LAPPLE
17170 BOLD VENTURE DRIVE
LEESBURG, VA. 20176
PLEASE EMAIL: JUDITHLAPPLE@GMAIL.COM WITH ANY QUESTIONS YOU MAY HAVE