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Minaret Chamber Music Camp

Part One of Two of Registration

Please complete the application form, then submit with application fee via fax or mail by May 1, 2017. The $45 application fee is non-refundable. For more information, contact the camp administrator at chambercamp@ut.edu. Confirmation of application and application fee receipt will be sent to all applicants.


Student First Name:
Middle Initial:
Student Last Name:
Street Address:  
City:  
State:
Zip Code:
Home Phone:
Student Cell Phone:  
Student Email Address:  
Gender:
    
Grade entering in Fall 2017:
Date of Birth:
Instrument:
School (Current):
Teacher's Name:
Shirt Size (adult sizes):
Name of Parent or Guardian (Primary):
Relationship to Student:  
Work or Cell Phone Number:  
Contact Email:  
Name of Parent or Guardian (Secondary):
Relationship to Student:  
Work or Cell Phone Number:
Contact Email:  
Medical Insurance Company (name):
Policy Number:
Name of Physician:
Physician's Phone Number:
Please describe any allergies or health concerns:  
Type of Camper:
    

To submit the application form, please click submit form. You will be redirected to the application fee payment form.