Jazz Camp Registration

Louisiana Jazz Camp 2016 Registration

Thank you for your interest in the 2016 Summer Jazz Camp at LSUS. Camp tuition is $160 per week and registration ends June 15th. (Register early and save: $140 per week by deadline April 30 and $150 per week deadline May 31.) To complete your registration, simply fill out this form and mail it with your payment made out to: Shreveport Summer Music Festival, PO Box 4125, Shreveport, LA 71134.

Jazz Camp Registration Form

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Fields marked with an * are required

I will be enrolling in (choose one or both): *

Week 1, 15-20 June
Week 2, 22-27 June

Student First Name *

Student Last Name *

Street Address *

City *

Zip / Post Code *

Student Mobile Phone

Student Home Phone

Student Email *

Parent Name *

Parent Mobile Phone *

Parent Home Phone

Parent Email *

Please list any special/medical needs:

Please list any medications we should know about:

Emergency Contact Information

In case of emergency, notify:

Name *

Address

Mobile Phone *

School attended this year:

What instrument do you play? *

Do you own your instrument?

Are you in your school jazz band?

Please list any other jazz performance experience you have: