Rockland Rock Band Camp

Name: *


Age: *


If under 18, Parent name: *


Address *


City *


Home phone: *


Cell phone: *


Email: *


Best contact number in case of an emergency: *


Main Instrument/Singer: *


Other instruments played: *


Teacher (if currently taking lessons): *


Do you sing?lead? backgrounds? *


Years playing/singing: *


Styles (artists) of music played (by order preference): *


Reading ability (tab, notation, chord chart, rhythm charts, etc): *


July 15th week *
None Full day 1/2 day

July 29th week *
None Full day 1/2 day