Register Institute Registration 1Information2Code of Conduct3Supporting Materials FacebookThis field is for validation purposes and should be left unchanged.Student InformationStudent Name* First Last Contact Email* Parent/Guardian email if Student does not have their ownStudent Phone*Parent/Guardian Phone if Student does not have their ownAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Student's Age, as of first day of camp*Please enter a number from 9 to 20.Student's Grade (recently completed)*Please enter a number from 4 to 12.Student's School*Please enter a number from 4 to 12.Student's Birthdate* MM slash DD slash YYYY Gender* Male Female Instrument*Please SelectViolinViolaCelloDouble BassCurrent Working Piece or Book*For Suzuki book, list piece number or list title and composerCurrent Teacher InformationCurrent Teacher's Name* First Last Current Teacher's Email Current Teacher's Phone*Parent InformationParent Name* First Last Parent Email (if different than Contact Email above) Parent Phone*Add another parent? Yes No Parent Name (2) First Last Parent Email (2) Parent Phone (2) Media Release and WaiverI hereby authorize Rocky Mountain Summer Conservatory to publish the photographs taken of me or my minor child, and my name of the minor child’s name, for use in printed publications and website. I acknowledge that neither the minor child nor I will receive compensation for the use of photos. I further agree that said photos and names in any publication and website produced by RMSC confers upon the minor child or me no rights of ownership whatsoever. I release RMSC, its contractors and its employees from liability for any claims by me or any third party in connection with my participation. RMSC admits students of any race, color, gender, national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, gender, national and ethnic origin in administration of its educational policies, admissions policies, and scholarship programs, and other school administered programs. Registration FeeYour registration will be considered final once registration is received.Registration Fee Price: Payment Options Credit Card through PayPal (fees apply) Check through Mail Billing Name (Name on Card)* First Last Billing Email* Billing Address* Use Student Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code