Language
English (Australia)
Camp Registration Form
Register here for 2020 Camp/ Workshops
Applicant Details
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
*
-
Day
-
Month
Year
Date
Email
*
example@example.com
Phone Number
*
-
Mobile Number
Phone Number
-
Area code
Phone Number
I am registering for
Strings camp at Frederick Marsden Youth Camp
Bands workshops at Watson Park Dakabin
I am a registered member of MYME
*
Yes
No
I am a member in
*
Junior Strings
MYSO
MYCE
Stage Band
I am registering as a
*
student
teacher
supervising adult
School/College
*
Year level
*
3
4
5
6
7
8
9
10
11
12
College/university
Teacher
Instrument/s
Years on instrument/s
Instrumental Music teacher
Private Music Tutor (if applicable)
Approx. AMEB Level (if appropriate)
Do you have special dietary requirements
*
Vegan, gluten free etc
Do you have medical requirements
*
Asthma inhaler etc
Emergency/ next of kin contact details
Parent/ Guardian details (under 18's)
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Billing details
Please provide a MONITORED email address for billing purposes.
Billing Email address
*
example@example.com
By checking this box, I confirm that I am participating in the activity outlined above, am over 18 years of age, or have parental/guardian consent to apply
*
Yes
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AM/PM Option
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