Form TEST – Rock and Roll Institute

Musician Name*

First Last

Musician Age*

At the time of the 2023 camp season.

Phone*

Parent/Guardian if under 18. Will be used for communication from camp director in the event of necessary communications about gear, availability, etc.

Emergency Contact*

First Last

Emergency Contact Phone*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Email*

Parent/Guardian if under 18.

What is your primary instrument?*

Select one.

In the event of a shortage, what other instruments can you play, and would be willing to play, for the duration of at least one week of enrollment?*

Check all that apply.

Guitar
Bass
Drums
Vocals
Keys
Other
None

Which week(s) would you like to attend?*

Week 1 - $399
Week 2 - $399
Both weeks - $749

How long have you played your primary instrument?*

Have you had private instruction? If so, how long and with whom?*

What equipment will you bring to camp?*

Example: guitars, amps, bass, bass amps, drums, keyboards, stands

What equipment would you need to borrow from camp?*

Equipment is based on availability and will be on a first-come-first-serve basis.

What genre of music would you most like to play with your band at camp?*

Examples: death metal, ska, rock and roll, pop, funk, etc.

List 4 songs with artist names that you would like to cover during camp.*

Example: AC/DC- Back in Black, Bee Gees- Stayin' Alive

Headshot*

Please upload a clear, recent headshot. This will be used for efficiency in band placement, skill assessment, etc.

Accepted file types: jpg, pdf, Max. file size: 32 MB.

Would you like a Rock & Roll Institute Shirt?

An additional $10 will be added to your total. Shirts will be available for public purchase for $20 at R&RI events.

Yes

Please choose a t-shirt size

Allergy/Medical

Please describe any allergy, medical, or any other information you feel the staff needs to know. This information will be kept private and shared with staff in an as-needed basis.

Please let us know how you heard about us?

Facebook
Email
Poster/Flyer
A friend
An institute instructor
Radio
Your school music teacher
Your independent music teacher
Other

Please describe who or how - Thanks!

Make a donation!

If you would like you can enter a donation amount to be added to your total. We are able to provide tax letters on request.
We can’t thank you enough. YOU ROCK!

RnRI Camper Agreement*

I understand that Rock & Roll Institute will do their best to accommodate all camper preferences regarding instrument choice, coach requests, and band selections, but I am aware that the RnRI staff can only organize bands based on what they are given with enrollment. And if I list myself as a multi-instrumentalist at time of registration, I am aware that I might be asked to play one of my secondary instruments during camp instead of my instrument of choice. I understand if I miss camp days due to illness or conflict, I may not be able to perform all songs with the band at the final concert, with discretion belonging to my band's instructor.

I have read and understand.

Discount Code

( Be sure to 'click' apply after entering your code. )

Total

$0.00

Phone

This field is for validation purposes and should be left unchanged.

Rock and Roll Registration