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.
Enter Email Confirm Email
What is your primary instrument? REGISTRATION CLOSED FOR WEEK 1 DRUMMERS AND VOCALISTS. Registering for these options will result in a refund.*
Select one. REGISTRATION CLOSED FOR WEEK 1 DRUMMERS AND VOCALISTS. Registering for these options will result in a refund.
- DJ
- Guitar
- Bass
- Drums
- Vocals
- Keys
- Other (please specify in "what will you bring to camp" section)
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.
- DJ
- 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: turntable, 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. DJs will be provided with materials that they need- no need to specify.
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. DJs- What type of music are you into? Would you be open with working with a band, or do you prefer to perform solo?
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, jpeg, pdf, heif, png, heic, Max. file size: 10 MB.
Would you like a Rock & Roll Institute Shirt?
Shirt will be our new "bullseye" design logo. 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
Email
This field is for validation purposes and should be left unchanged.

Rock and Roll Registration