2022 Chaparral Chamber Music Workshop Registration

2023 Chaparral Chamber Music Workshop
Registration February 20 to March 15, 2023.
- Early registration is encouraged to guarantee your spot.
- Late registration only possible pending space availability.
- Ensemble placements are made April 1-15.
- Groups and sheet music available May 1-5, if all are registered by March 15.
You are encouraged to pay online through this form using a credit or debit card.
- You DO NOT NEED a PayPal account to pay your registration fee online.
- If you do not have a Paypal account, sign in as a "guest".
- If you need to pay by check, after submitting this form, mail your check to: Debbie O'Brien 4500 N. Cypress Circle, Prescott Valley, AZ 86314
Please submit a separate form for each participant.
- Only one student may be registered at a time.
- When you are done filling out the form, scroll to the bottom and click "SUBMIT FORM AND PAY" button.
- If your registration was successful you will get an email confirmation.
Participant Information
Online Registration - Estimated registration completion time is 5 minutes. No option to save partially completed registration form.
Participant's Full Name*

First NameLast Name
Participant Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail Address where you'd like to receive confirmation and information:*
example@example.com
Phone Number: *

Area CodePhone Number
Any comments or clarifications you wish to add including musicians you'd like to play with and/or repertoire you'd like to play. If you are coming with a pre-formed group, please list names/instruments of the group members and tell us if you are coming with repertoire to work on. Whichever option you choose, we will contact you to confirm all details. Thank you!
If under 18, Parent/Guardian Phone Number:

Area CodePhone Number
Food allergies
Track, Instrument and Level
The primary instrument you will be playing: *
I am registering for (Choose One):*

Youth Track (entering 7th-12th Grade, in Fall 2023)Adult Track (18-up, includes adult learners)
(Optional) 2nd instrument you'd like to play:
Playing level on the primary instrument listed above; for description click on link below.*

Novice, includes adult learnersIntermediateAdvancedExpertProfessional
https://tinyurl.com/y29vpjxr
(Optional) Playing level on the secondary instrument listed above; for description click on link above.

Novice, includes adult learnersIntermediateAdvancedExpertProfessional
Photo/Video Release
By registering you give Chaparral Chamber Music Workshop permission to use participant's photo in marketing materials and on the website. Check box below to opt out.

Opt out
Payment
Course Fees:

Full payment of all fees (in U.S. Currency) must be received in order for the registration to be processed. All fees, whether online or check, must be received by March 31.

The course fee is $225.00 which includes a non-refundable $25.00 registration fee.

To Pay Course Fee in Full:

You are encouraged to pay online through this form. YOU DO NOT need to have a PayPal account to use this system and may use credit card or debit card. If you do not have a Paypal account, sign in as a "guest".

To Apply for a Scholarship:

To apply for any Adult or Youth Scholarship, complete the registration and answer the questions under Scholarship Request, below.

Adults and non-Prescott Youth- A limited number of need-based scholarships are offered for youth and adults. You must register for the workshop and indicate your request for a scholarship no later than March 25. You are encouraged to make your request early. If you are seeking a scholarship, please fill out the information below.

Prescott Youth only- automatic JS Acker Scholarships are available to those 17 and under with a Prescott mailing address. This scholarship covers half or full tuition less the $25 registration fee. Please apply and the Director will contact you. Choose this option ONLY if your mailing address lists Prescott, AZ as the city and state.

If you need to pay by check, please

• make your check out to Chaparral Chamber Music Workshop
• write the participant's name in the Memo field
• and mail it to:

Chaparral Chamber Music Workshop
c/o Debbie O'Brien 4500 N. Cypress Circle, Prescott Valley, AZ 86314

Chaparral Chamber Music Workshop reserves the right to cancel and refund fees due to insufficient enrollment. A $35 service fee will be charged for all returned checks.
Current Date:*

MonthDayYear
REGISTRATION & FEE PAYMENT: (1) Click on 1 of the 4 choices below (2) If applicable, fill out the scholarship request (3) Click "Submit Form and Pay" button at the end of the form OR YOUR REGISTRATION WILL NOT BE RECEIVED. *
prevnext( X )
I am paying the normal Chaparral Chamber Music Workshop Fee$225.00

I am paying the $25 CCMW registration fee only. I am applying for a scholarship and will pay the balance upon notification of my scholarship amount.$25.00

I am paying by check and will mail it in. $ Free

I have applied and been accepted as an intern and am paying the $25 registration fee.$25.00
Prescott Youth only:

Yes, please offer me a JS Acker Scholarship.
Adult and non-Prescott Youth:

Yes, please offer me a need-based scholarship.
I qualify for a scholarship because:

I qualify for government assistance.I have other qualifications for a need-based scholarship (Please elaborate below).
The amount I feel I can afford is:
Your responses are completely confidential.
Final Step and Payment
After completing the registration form, all applicants including those requesting scholarship, click the orange button, "Submit Form and Pay" at the bottom of this page.

"Submit Form and Pay" button will automatically direct you to PayPal and to pay by credit card.
- At this point, those paying online will pay by credit or debit card.
- When you get to the screen that says "Pay with debit or credit card", fill out your info and where it says "Save info & create your PayPal account", slide the round button to the left to avoid going into PayPal.
- If you are paying by Check, be sure to click on "Submit Form and Pay", you are now done with the registration form. You may print out your form, close your browser and mail your check. Checks must be received by March 31, you will get an email confirmation that your check was received.
Registration is NOT complete until payment is received.

If your registration was successful, Debbie will approve your registration and you will then receive an email confirmation.

For help with online registration, or ANY questions, please email Debbie O'Brien at register@chaparralchambermusic.org

We look forward to making music with you in Prescott!
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2023 Chaparral Chamber Music Workshop

Participant Information

Online Registration - Estimated registration completion time is 5 minutes. No option to save partially completed registration form.

Track, Instrument and Level

Photo/Video Release

Payment

Final Step and Payment