Vienna Band Camp 2024 Registration
Dates of camp are June 20-July 12 at Longfellow School. No Camp on July 4 & 5.

Reminder - Beginning Band students MUST bring a "Standard of Excellence" Book 1 for their instrument with them on the first day.  You can purchase this easily online, or by going to Foxes or Music and Arts.

If you have questions regarding the camp activities, classes, curriculum, etc. please contact Matt Baker - mcbaker1@fcps.edu.

If you have questions regarding this form or registration, please contact Christina Weise at cbweise@fcps.edu.

There are no refunds for fees paid after June 7.
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Which program will you be participating in? *
Student First Name *
Student Last Name *
Student Age *
Student T-Shirt Size *
These are ADULT sizes.
Street Address *
Number or Apt and Street Name
City *
State *
Zip Code *
Current School *
Current Grade (2023-24 School Year) *
Reminder - VBC is for students 4th grade through 8th grade
Instrument *
Reminder - Beginners should have chosen an instrument prior to coming to VBC and arrive with that instrument on the first day.
Number of years you have played this instrument *
If you are a beginner please type "0"
Student Home Phone Number *
Parent #1 Name - first and last *
Parent #1 Work Phone Number *
If none then please type "none"
Parent #1 Cell Phone Number *
If none then please type "none"
Parent #1 Email Address *
If none then please type "none"
Parent #2 Name - first and last *
If none then please type "none"
Parent #2 Work Phone Number *
If none then please type "none"
Parent #2 Email Address *
If none then please type "none"
Parent #2 Cell Phone Number *
If none then please type "none"
Would you be willing to be included on our carpool list?  If so, please select the ELEMENTARY SCHOOL that you live closest to.
Note - We do NOT arrange carpools for you.  We simply provide you with a list of others that live near you and would like to carpool.  This will be sent via email the week prior to the start of camp as well as hard copies provided in the lobby on the first day.  If you select this options, please understand that your location and email address will be shared with the others electing to be on this list as well.
Emergency Care Information
Physician's Name *
Physician's Phone Number *
Please list any allergies, medical conditions, or medication that are important for us to know about in case of an emergency.
Does this camper have a latex allergy? Sometimes we use balloons to teach proper breathing technique. *
In case of emergency, please list at least TWO people that we can contact if we cannot reach you.  Please also list their best contact information in this text box for each one. *
Emergency Care and Student Conduct Agreements
Parent Agreement - The camp has my permission to seek emergency care for my child at the nearest hospital when I or my physician cannot be contacted.  The hospital and its medical staff have my authorization to provide any treatment which a physician deems necessary for the well-being of my child.  I understand that the camp will provide adequate supervision during the operating hours of the camp and will provide full accident insurance for my child while in camp.  I will not hold the camp or the Fairfax County School Board liable for bodily injury that might occur through accident while my child is at the camp beyond the limits of the camp insurance carried for such injury. I will keep my child home if they are experiencing any sickness or covid symptoms.

Covid Information - Camp will be held in-person and indoors at Longfellow MS. Current CDC standards and mitigation strategies will be followed to ensure student and staff safety. Vienna Band Camp, MHSBPA, and FCPS are not liable for covid-related illness. By registering my child to attend and participate in Vienna Band Camp, I acknowledge the contagious nature of the Covid-19 virus. I understand and voluntarily accept any and all risks associated with attending Vienna Band Camp, including Covid-19 exposure and/or infection. I further release and agree to hold harmless Vienna Band Camp, MHSBPA, and FCPS, including their members, staff, employees and agents, from any causes of action, claims, demands, costs, expenses, and/or damages arising out of my child’s participation in Vienna Band Camp.

Student Agreement - In order to ensure that the Vienna Summer Band Camp is an enjoyable and educational musical experience for all students, it is necessary that each student to accept the responsibility for his/her behavior and to participate in an acceptable manner.  Students must attend all classes while in the building and are not to leave the school grounds.  Areas of the school which are not in use by the camp are off limits to all students.  Failure to adhere to these rules and to follow regulations as established by the Vienna Band Camp staff will result in dismissal from the camp.

Acknowledgement of the agreements listed above. *
Photo Release Agreement

The parent/guardian of the student named above gives consent for the Vienna Band Camp staff to take photographs of the student during Vienna Band Camp.  They also give consent for the Vienna Band Camp staff and/or the vendors who generously donated materials and supplies to the clarinet program at Vienna Band Camp to use those photographs for any purpose related to the Vienna Band Camp activities, including the Vienna Band Camp Clarinet Facebook Page, Vienna Band Camp's website and donating vendors' advertising.

The law requires that we ask for your permission to use photo/images of your child.  Pursuant to law, we will NOT release any personal identifiable information without prior written consent from you as parent or guardian.  WE ARE ONLY ASKING FOR PERMISSION TO USE PHOTOGRAPHIC IMAGES OF YOUR CHILD ALONG WITH THE LOCATIONS OF THE CAMP.  Your child's name and other personal identifiable information will not be disclosed.

Acknowledgement of the Photo Release Agreement Listed Above *
Payment required now
Once you push submit for this form, you will be taken to a confirmation page with instructions for how to submit payment via PayPal.  You must complete payment for registration to be complete.  Form submissions without payment will be automatically deleted.
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