Chamber Music Workshop Registration

2018
Summer Chamber Music Workshop Registration
Monday August 13th - Saturday August 18th

Register for the Chamber Music Workshop in just four easy steps!
Each section must be completed before advancing to next step!
Early Bird registration by June 18th (discount is deducted in Step 4.)

*Tuition is $300. Register by June 18th and receive $10 off your tuition! Use coupon code: earlybird. Register another family member for $5 off each additional family member. Please register the first child before registering a sibling, then complete this form for the sibling.
STEP 1: Student Information
Full Name*

First NameLast Name
Current Age*
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What is your instrument?*
Years Studied*
List your current piece and/or Suzuki Book level*
What is your current piece?
I am registering for: (see sample schedule for full workshop vs orchestra only schedule - times are subject to change www.elliottfamilyquartet.com/ChamberWorkshopStudentDocs.html)

The entire workshop ($300) - August 13th - 18th, 9am - 4pmThe Chamber Orchestra only ($90) - August 13th - 18th, 2 hours each dayIf I am not accepted to the entire Chamber Workshop, I would like to be considered for the Chamber Orchestra Only.
Are you interested in participating in the Workshop Solo Competition? If yes, see below.*

YesNo
Workshop Solo Competition

If you are interested in the solo competition,
visit the competition page for more information.
Private teacher name (indicate "none" if no private teacher)*

First NameLast Name
School Orchestra
Other Orchestra
Parent Information*

First NameLast Name
Relationship to student*
Mobile Phone #*
Home Phone #*
E-mail you want to receive workshop information*
Comments/Special Requests
Chamber Music Workshop Home Page

You may print the completed form mail it if you prefer. Printing is available in the final step.

Audition Requirements in next step...

STEP 2: Audition submission

A video audition is required for all students. The audition is important for assigning music and determining the level of the student.
Please submit two videos with the following audition requirements:

1. A two or three octave major scale

2. A polished solo piece that shows your ability. The piece should be less than 5 minutes. If it is longer, please play an excerpt from the piece.

3. The scale and the piece should be recorded in two separate videos.

4. Upload the videos to YouTube as "Unlisted" and include the link below.

5. If preferred, students may also submit their videos by dropbox or other online storage. After uploading the videos to your personal dropbox account, include a link to it below. Dropbox is a free online storage service. Click here for a short video explaining how to share your file with dropbox.

6. Your application will not be complete until your video has been received.

The video quality is not important and can be recorded with a cell phone or camcorder, it just needs to have clear audio.

Email dweems4@gmail.com for questions or concerns.
Copy your scale YouTube or Dropbox link and past it below.
Copy your solo piece YouTube or Dropbox link and past it below.
*

I will email a link to my videos to dweems4@gmail.comA link to my video is listed above
Chamber Music Workshop Home Page

Medical/Photo Release in next step...

STEP 3: Medical/Photo/Video Release
I am a parent or legal guardian of the registered who is currently under the age of 18. I grant permission for the registered student to attend the Summer Chamber Music Workshop. The Workshop cannot assume financial responsibility for lost, stolen, or damaged personal property. I understand that students are responsible for their own instruments while in attendance.

Should an accident or illness occur, necessitating medical treatment for my child, this registration shall serve as my authorization for the emergency care physician/dentist to administer treatment that is appropriate. Further, I acknowledge my financial responsibility for any treatment rendered in such an emergency.

I furthermore understand workshop often takes photographs or videos of participants during its activities or events. I grant permission that these photographs or videos may be used in publications, presentations, websites or promotion of the Chamber Music Workshop. The Workshop will not identify me or my child by name, or release any other personal information.
Signature*

Clear
Electronic Signature: *

First NameLast Name
Current Date*

MonthDayYear
Chamber Music Workshop Home Page

Pay, print, and submit in the next step...

Step 4: Submit form and make payment.
Payment Options:

You may pay the full tuition price of $300 or choose from the options below. A minimun $50 deposit is required with registration ($10 is nonrefundable). Half of remaining balance is due by July 1st. Full tuition is due by July 15th.

Register by June 18th to receive $10 off your tuition! Use coupon code: earlybird

Save an addional $5 by registering a sibling. Select the SIBLING option below to register a sibling. Registration of the first sibling is required for the sibling discount.

LUNCH OPTIONS:
Students may pack a lunch or purchase the lunch plan below. Click here to see the lunch menu.

Chamber Orchestra only students are free to purchase a lunch and come early, then stay for the orchestra rehearsal.

To secure the lunch plan, it must be reserved with your registration!
Chose your lunch plan below.*

Lunch for the entire week $40No lunch plan. I will pack a lunch each day.

CHOSE ONE OPTION BELOW. Minimum required is a $50 deposit. You will be billed for the remaining balance in two installments: July 10th and on July 25th. Register by June 18th to receive $10 off your total. Use coupon code: earlybird (not valid for Orchestra Only students.) If you have any other coupon codes given to you, enter it below. (You must chose one of the options for the coupon to work)*

Deposit only - The remaining tuition will be billed.$50.00

Half Tuition$150.00

Full Tuition$300.00

SIBLING Half Tution - Valid with one regular priced sibling$147.50

SIBLING Full Tuition - Valid with one regular priced sibling$295.00

Orchestra only Tuition$90.00

Lunch Plan$40.00

Enter coupon

Total $0.00

Comments or Concerns:
Financial Need Information. Please indicate below if you have a financial need. Give a general description of your financial need. There may be a limited number of scholarships available. However, the $50 registration fee is required ($35 if you register before June 8th) If we are unable to grant you a scholarship, your registration fee will be refunded.
Refund Policy:

Full refund minus $50 application fee if cancellation is before July 8; 50% refund if cancellation is between July 9 and July 25; cancellations between July 26 and August 6 are only for EXTENUATING circumstances and refunds will be 25%; no refund if cancellation is after August 6th.

In the event we are unable to accept your child, a FULL REFUND minus a $10 processing fee will be issued. Students will be confirmed of thier participation in the workshop by June 30th.
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

STEP 1: Student Information

STEP 2: Audition submission

STEP 3: Medical/Photo/Video Release

Step 4: Submit form and make payment.