Rock and Roll Institute
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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
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American Samoa
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District of Columbia
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Iowa
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Louisiana
Maine
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New York
North Carolina
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Northern Mariana Islands
Ohio
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South Carolina
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Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
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Armed Forces Pacific
ZIP Code
Email
*
Parent/Guardian if under 18.
What is your primary instrument?
*
Select one.
Guitar
Bass
Drums
Vocals
Keys
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
Size
Youth Large Tee - $10
Small Tee - $10
Medium Tee - $10
Large Tee - $10
Extra Large Tee - $10
XX Large Tee - $10
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!
$25
$50
$75
$100
$150
$200
$250
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.
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Rock and Roll Registration
Which camp would you like to register for?
KID'S CAMP
ADULT CAMP