Total Camp Fees (Cash, Check or Money Order made out to “Daniel Santelices”. Please Mail to him at 304 Stephenson Street, Shreveport, LA 71104 *
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Music Theory Level *
Instrument *
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Violin
Viola
Cello
Bass
Flute
Oboe
Clarinet
Bassoon
French Horn
Trumpet
Trombone
Tuba
Piano
Other
School AND Grade for 2019-2020 school year *
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Parent/Guardian Names *
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Mailing Address *
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Other preferred contact email address(es), in addition to the one you have already provided above (indicate a student or parent email) *
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Parent(s) Mobile Phone Number(s) *
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Student Mobile Phone Number
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Please any/all of the following coaching time blocks that you WOULD be able to attend. It is in the group’s best interest to meet at the same time, if possible. *
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Please check days with specific scheduling conflicts regarding the above times. You will list the conflict in the section below. Leave blank, if no conflicts
Please list your scheduling conflicts with the day/time from the above sections
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Please list polished solo or Band/Orchestra pieces you currently/recently played. (This info is needed in lieu of a live audition and to determine the student’s group placement) *
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Please list REQUESTS for other participating students, that you have already spoken to who would like to be in your ensemble. Also, any particular chamber music pieces you would be interested in learning during the week. (I will try and do my best to accommodate)
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Known Food Allergies *
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Parent Volunteers: My parent below would be willing to assist with one or more of the following. Also, indicate if you would be willing to Chair (or be in charge of) Snacks, Pizza or the Reception. THANK YOU in advance.
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Parent Volunteer Categories (check all that apply)
My School Music OR Private Instrument Teacher RECOMMENDS ME! Here is their contact information (email & phone no.) *