Clone of 2025 Midsummer Music Madness Registration Form

Midsummer Music Madness Registration June 15-19 & June 22-26, 2026 (9:00am - 12:30pm)

Please note that your registration will not be considered complete until the registration fee has been received. Fees may be paid online at www.fgbyo.com or mailed to: FGBYO P.O.Box 91103 Lake Charles, LA 70609. If you choose to pay online via PayPal, a 3% processing fee will be applied.
Student Information
Student's Name

First NameLast Name
Address

Street Address

CityState / Province

Postal / Zip Code
Age
Grade
School
T-Shirt Size
Does your child know how to read music?
Please indicate which (if any) of the following instruments, your child already knows how to play. (Select as many as apply)
Does your child have any of the above instruments available for personal use during summer camp? If so, please list them.

Students are asked to choose one primary instrument, and are allowed up to two elective instruments to enjoy during camp. Please indicate your child's interest by selecting their 1st, 2nd, 3rd, 4th choice, etc. Please note that instruments are limited and classes will be assigned on a first come, first serve basis, so your first choice may not always be possible.

Rows	1st Choice	2nd Choice	3rd Choice	4th Choice
Violin
Cello
Viola
Guitar
Beginner Piano
Voice(Secondary only)
Ensemble

Parent/Guardian Information
Name

First NameLast Name
Relationship
Best Contact Number
Format: (000) 000-0000.
E-mail
example@example.com
Does the student have any allergies, chronic illness, or medical conditions that we should be aware of? If yes, please describe.
Emergency Information
Additional Emergency Contact

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Media Release

I give the Dr. Francis G. Bulber Youth Orchestra permission to include my child in various media related productions. These may include Facebook, adverstisements, newspaper articles/photos, recruitment pamphlets/fliers/brochures, local television interviews/filming (individually or with a group), and/or FGBYO's own webpage. I hereby give the Dr. Francis G. Bulber Youth Orchestra, Inc. permission to use my child's
Name
Picture
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
Date
Name of Person Registering Student
Registration Fee of $325 for FGBYO Members and $375 for Non-Members

Please remember that your registration is not complete until we receive your registration fee. Fees can be paid online at www.fgbyo.com under the "Midsummer Music Madness (Summer Camp)" heading or mailed to FGBYO Box 91103 Lake Charles, LA 70609. If you choose to pay online via PayPal, a 3% processing fee will be applied.
Should be Empty:

Midsummer Music Madness Registration June 15-19 & June 22-26, 2026 (9:00am - 12:30pm)

Student Information

Media Release

Registration Fee of $325 for FGBYO Members and $375 for Non-Members