Untitled Document

Your Name:

Street Address:

address1
address2

City, State Zip:

Your Telephone & email:

e-mail address:

EMERGENCY PHONE NUMBER (parent work #/cell #, etc.)

School Attending:

Instrument:

Your Director's Name:

Camp Attending:

Drum Major Camp	Section Leader/Leadership Camp	Percussion Camp	Color Guard Camp	Dance Camp

Your Personal Information:

Grade (2010-2011)
Gender (M/F)
Adult T-Shirt Size (S, M, L, XL, XXL, XXXL)

Do you plan to stay in the residence hall or commute:

Residence Hall
($250.00 total camp fee)

I will commute
($160.00 total camp fee)

I want to room with (leave bank if you want us to assign you a roommate):

Meal Card:

I WILL purchase a meal card ($55.00)
I WILL NOT need a meal card ($0.00)

Comments (please include any special requirements (dietary, physical, etc.)

MEDICAL RELEASE FORM
(please print, complete and mail with your payment)

Camp fees:

$250.00 Resident Camper (INCLUDES THE MEAL CARD)
$160.00 Non-Resident Camper (NO MEAL CARD INCLUDED)
$55.00 Meal Card (Optional)

Please mail check or money order payable to the KSU Bands:

Kansas State University Music Camps
K-State Band Office
226 McCain Auditorium
Manhattan, KS 66506