Franklin Band & Orchestra Camp
June 29 to July 23, 2015
Monday through Friday
Orchestra: 8:30 AM to 12:30 PM
Band:
9:00 AM to 1:00 PM
Franklin Camp Features:
 Sectionals with instrumental specialist
 Full band and orchestra classes for all levels of experience.
Ages 9 and up/Rising 4th grade and up
 Classes for Elementary through High School
 Special classes for beginning Band and Strings students.
 Concert performance on the last day featuring all
performance groups.
 Students may study the following instruments:
All woodwinds, all brass, all percussion, all strings.
(Piano, Guitar and Recorders are not offered)
 Auditions and First Day information will be available online at
www.fcps.edu/FranklinMS
 Jazz Band Program
June 29 - July 23, 2015 (No camp July 3th)
CAMP USE ONLY:
8:30 AM – 12:30 PM
9:00 AM – 1:00 PM
Orchestra
Band:
Ck#______________
Amount __________
Reg #____________
FULL payment of $250.00 is required for application to be complete. After June 1st, the registration fee is
$275.00. There will be no refunds after June 15th. Your cancelled check is proof of registration.
For more information, please email one of the camp directors:
Send checks and this completed form to:
Franklin Band Boosters
3300 Lee’s Corner Road
Chantilly, VA 20151
Band:
Lawrence Walker, Director, lhwalker@fcps.edu
Orchestra: Cindy Crumb, Asst. Director, crcrumb1@fcps.edu
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Ensemble placement will be determined by auditions held the first day of camp. Audition music is ONLY available
online. Check our website for audition music and other information: www.fcps.edu/FranklinMS.
Please send a snack. Snacks are also available for purchase at Franklin Snack Shop.
Camp instructors will notify students the first day of class as to what items/books may be needed.
Check if you would like to have your name, address and phone number included on a CARPOOL LIST. Attach a
stamped, self-addressed envelope to your application if you would like the carpool list mailed to you. Campers
registering after June 1st will not be included on the list. The camp does not provide transportation.
Please Print
Camper’s Name __________________________________________
Age at Camp __________________
Address _________________________________________________
Current School _________________
City _________________________ State ________ Zip Code ________ Current Grade _________________
Name of Parent/Guardian available during the day _________________________________________________
Phone Numbers: Home___________________ Office____________________ Other _____________________
This application has my approval and consent.
Parent/Guardian Signature ____________________________________________________________________
Please answer all the following questions:
Check ONE of the following programs:
Band
Orchestra
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Has student ever previously attended this camp?
No
Yes If yes, years: ___________
Instrument________________ Yrs. played _________
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Please circle T-shirt Size:
YM
YL
AS
BAND STUDENTS:
Circle the scales you know:
F Bb Eb Ab G
D
A
E
Do you know the Chromatic scale? □ Yes □ No
AM
AL
AXL
PERMISSION FOR EMERGENCY CARE
Name of Pupil: Last________________________ First_________________ MI______ Date of birth ______________
Parent/Guardian: ____________________________________________Home Phone Number: __________________
Cell Phone Numbers (Mother):________________________________ (Father): ______________________________
Emergency contact (Other than parent): _________________________________ Telephone: ___________________
Parent/Guardian Insurance: ______________________ Company and Policy No.: __________________________
Name of Family Physician: ____________________________________ Telephone: __________________________
Allergic to Medication (Specific Type) ________________________________________________________________
Camp Personnel will not dispense medication.
Is the pupil under physician’s care for health needs on a continuing basis?
YES
NO
Is the pupil under medication or treatment on a continuing basis?
YES
NO
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Franklin Band & Orchestra Camp has my permission, in an emergency when I (or my physician) cannot be contacted, to take my child to
the emergency room of the nearest hospital. The hospital and its medical staff have my authorization to provide treatment which a physician
deems necessary for the well-being of my child.
Signature of Parent_____________________________________________________ Date______________________
 Parents: If you need a Flex Savings form signed, you must bring it to camp!