Prelude Chamber Music Registration Form 2022

Prelude Chamber Music Summer Camp 2022 Registration

Please complete this form and pay deposit to register for Prelude Chamber Music Camp, Jacksonville, FL, June 20 -25, 2022.
Full Name of the Student/Participant *

First Name Last Name
Age of Participant *
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Main Contact Phone Number *

Area Code Phone Number
Main Contact Email *
General Education Information
Select the Student's Grade Level for Fall '22 *
What School Does the Student Attend? *
Name of School or None
Music Education Information

Helps us organize ensembles appropriately
What instrument(s) does the student play? And how long has he/she played each? *
Music Teacher's Name *
Please enter the student's known music teacher or enter None if not studying with a teacher.
Music Teacher's Phone

Area Code Phone Number
Music Teacher's Email
Selections and Placement Auditions

All participants must prepare and record a placement audition after registration. First, complete registration and pay the $100 deposit. Next, complete and submit video placement audition. After registering, follow instructions at www.preludechambermusic.org/placement-auditions.
Please select intended participation *

Foundation/Primary: Prelude Chamber Music Summer Camp June 20-25, $350 (per participant in foundation/elementary half day program, at least 1 year of experience needed and at least 8 yrs old, hours 9am - 1pm M-F, + Sat concert, placement audition required) Prelude/Intermediate: Prelude Chamber Music Summer Camp June 20-25, $450 (per participant in intermediate track full day 9-3p M-F, + Sat concert, placement audition required) Prelude Intensive/Advanced: Prelude Chamber Music Summer Camp June 20-25, $450 (per participant in advanced track full day 9-3p M-F, Sat concert, placement audition required) Prelude Spirit AM: For adults only who love to play chamber music, all levels accepted. Prelude Chamber Music Summer Camp June 20-25, $350 (per participant for half day program, at least 1 year of experience needed and at least 19 yrs old, hours 9am - 1pm M-F, + Sat concert, placement audition required) Prelude Spirit PM: For adults only who love to play chamber music, all levels accepted. Prelude Chamber Music Summer Camp June 20-25, $350 (per participant for half day program, at least 1 year of experience needed and at least 19 yrs old, hours 11am - 3pm M-F, + Sat concert, placement audition required)
Do you play in any orchestras, ensembles or chamber music groups?
If yes, please tell us the name(s) of the organization and list the ensemble or orchestra, i.e. Douglas Anderson String Chamber Music students and/or orchestras, La Villa Chamber Orchestra, Pine Forest strings, JYSO - Philharmonic, River City Youth Orchestra - Aria Strings, etc. If none, you can skip this.
Are you coming to camp with a preformed group?
If yes, please indicate the name of the group and/or the names of others in your ensemble. All students must register individually. Camp deposit and tuition is per person. If you have a pre-formed group, we encourage you to audition together and will place you together if you wish.
T-Shirt Size *
Prelude Chamber Music T-Shirt will be provided at the Festival, please select the appropriate size. (1 per participant)
How did you learn about Prelude Chamber Music?
Parents and Guardians Information / Emergency

If registrant is under 18 years of age, complete this Parent/Guardian Section. We will use this for emergency contact information.
Full Name of Parent/Guardian 1 *

First Name Last Name
Relationship to Student *
Phone Number (Parent 1) *

Area Code Phone Number
E-mail (Parent 1) *
Full Name of Parent/Guardian 2

First Name Last Name
Relationship to Student
Phone Number (Parent 2)

Area Code Phone Number
E-mail (Parent 2)
Additional Contact for drop-off or pick-up

First Name Last Name
Media and Performance Release
I hereby authorize the Prelude Chamber Music Inc., and the photographer/ videographer/ editors and others acting on their behalf to video, record and photograph the public music concerts and camp activities for Prelude's use, reproduction, and/or publishing. I also give permission for Prelude Chamber Music organization to use Prelude events' photographs, audio and/or video that may pertain to me including my image, likeness and/or voice without compensation. I understand that this material may be used in various publications, public affairs releases, recruitment materials, or for other Prelude related endeavors. This material may also appear on the Prelude Chamber Music Inc., Internet Web Page. This authorization is continuous and may only be withdrawn by my specific rescission of this authorization. Consequently, Prelude Chamber Music or project sponsor may publish materials, use my name, photograph, and/or make reference to me in any manner that the Prelude Chamber Music Inc., deems appropriate in order to promote/publicize the Prelude Chamber Music Inc., programs.
Camper/Performer/Composer name as media release reference

First Name Last Name
Parent/Guardian name as signature for media release

First Name Last Name
After you submit your registration form to us, you will be prompted to complete the $100 deposit and/or pay the tuition for the camp week. The concerts are free for family, friends and community to attend. If you need to make multiple payments or return to make a payment later, you can go directly to https://preludechambermusic.org/music-camp/payment
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Prelude Chamber Music Summer Camp 2022 Registration

General Education Information

Music Education Information

Selections and Placement Auditions

Parents and Guardians Information / Emergency