Rockland Rock Band Camp

Name: *


Age: *


Parent name: *


Address: *


City: *


Home Phone: *


Cell phone: *


Email: *


Perferred method of contact *
Cell
Text
Email

Main instrument/Singer: *


Other Instruments Played:


Teacher(if currently taking lessons):


Do you sing? Lead? Background? *


How long playing/singing: *


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


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


Weeks Interested in: *
July18th - 23rd
Aug. 1st - 8th
Both

How did you hear about the camp/contest? *
Google
Our Town Newspaper
Facebook
Instagram
Twitter
Referral

If referred, by who?