Application Form – Future Jazz BC

REGISTRATION FORM

(Use a separate form for each participant. Please complete all information)

One year of previous jazz band or private lessons is recommended.

Fields marked with an * are required

Participant Name *

Address 1 *

Address 2

City *

State *

Zip / Post Code *

Phone *

Email *

Instrument(s) *

Years of Experience *

School

T-Shirt Size (Adult) *

Parent/Guardian Name *

Parent/Guardian Home Phone *

Parent Employer *

Does your employer match charitable donations? *

Parent/Guardian Cell Phone *

Person authorized to pick up student *

Relationship *

Phone *

How did you hear about Future Jazz Camp? *

If Friend Type Friend Name